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Sample records for capture therapy years

  1. Neutron capture therapy: Years of experimentation---Years of reflection

    Energy Technology Data Exchange (ETDEWEB)

    Farr, L.E.

    1991-12-16

    This report describes early research on neutron capture therapy over a number of years, beginning in 1950, speaking briefly of patient treatments but dwelling mostly on interpretations of our animal experiments. This work carried out over eighteen years, beginning over forty years ago. Yet, it is only fitting to start by relating how neutron capture therapy became part of Brookhaven`s Medical Research Center program.

  2. Neutron capture therapy: Years of experimentation---Years of reflection

    Energy Technology Data Exchange (ETDEWEB)

    Farr, L.E.

    1991-12-16

    This report describes early research on neutron capture therapy over a number of years, beginning in 1950, speaking briefly of patient treatments but dwelling mostly on interpretations of our animal experiments. This work carried out over eighteen years, beginning over forty years ago. Yet, it is only fitting to start by relating how neutron capture therapy became part of Brookhaven's Medical Research Center program.

  3. Boron neutron capture therapy (BNCT) in Finland: technological and physical prospects after 20 years of experiences.

    Science.gov (United States)

    Savolainen, Sauli; Kortesniemi, Mika; Timonen, Marjut; Reijonen, Vappu; Kuusela, Linda; Uusi-Simola, Jouni; Salli, Eero; Koivunoro, Hanna; Seppälä, Tiina; Lönnroth, Nadja; Välimäki, Petteri; Hyvönen, Heini; Kotiluoto, Petri; Serén, Tom; Kuronen, Antti; Heikkinen, Sami; Kosunen, Antti; Auterinen, Iiro

    2013-05-01

    Boron Neutron Capture Therapy (BNCT) is a binary radiotherapy method developed to treat patients with certain malignant tumours. To date, over 300 treatments have been carried out at the Finnish BNCT facility in various on-going and past clinical trials. In this technical review, we discuss our research work in the field of medical physics to form the groundwork for the Finnish BNCT patient treatments, as well as the possibilities to further develop and optimize the method in the future. Accordingly, the following aspects are described: neutron sources, beam dosimetry, treatment planning, boron imaging and determination, and finally the possibilities to detect the efficacy and effects of BNCT on patients.

  4. Neutron capture therapies

    Energy Technology Data Exchange (ETDEWEB)

    Yanch, Jacquelyn C. (Cambridge, MA); Shefer, Ruth E. (Newton, MA); Klinkowstein, Robert E. (Winchester, MA)

    1999-01-01

    In one embodiment there is provided an application of the .sup.10 B(n,.alpha.).sup.7 Li nuclear reaction or other neutron capture reactions for the treatment of rheumatoid arthritis. This application, called Boron Neutron Capture Synovectomy (BNCS), requires substantially altered demands on neutron beam design than for instance treatment of deep seated tumors. Considerations for neutron beam design for the treatment of arthritic joints via BNCS are provided for, and comparisons with the design requirements for Boron Neutron Capture Therapy (BNCT) of tumors are made. In addition, exemplary moderator/reflector assemblies are provided which produce intense, high-quality neutron beams based on (p,n) accelerator-based reactions. In another embodiment there is provided the use of deuteron-based charged particle reactions to be used as sources for epithermal or thermal neutron beams for neutron capture therapies. Many d,n reactions (e.g. using deuterium, tritium or beryllium targets) are very prolific at relatively low deuteron energies.

  5. Neutron capture therapies

    Energy Technology Data Exchange (ETDEWEB)

    Yanch, J.C.; Shefer, R.E.; Klinkowstein, R.E.

    1999-11-02

    In one embodiment there is provided an application of the {sup 10}B(n,{alpha}){sup 7}Li nuclear reaction or other neutron capture reactions for the treatment of rheumatoid arthritis. This application, called Boron Neutron Capture Synovectomy (BNCS), requires substantially altered demands on neutron beam design than for instance treatment of deep seated tumors. Considerations for neutron beam design for the treatment of arthritic joints via BNCS are provided for, and comparisons with the design requirements for Boron Neutron Capture Therapy (BNCT) of tumors are made. In addition, exemplary moderator/reflector assemblies are provided which produce intense, high-quality neutron beams based on (p,n) accelerator-based reactions. In another embodiment there is provided the use of deuteron-based charged particle reactions to be used as sources for epithermal or thermal neutron beams for neutron capture therapies. Many d,n reactions (e.g. using deuterium, tritium or beryllium targets) are very prolific at relatively low deuteron energies.

  6. Iodine neutron capture therapy

    Science.gov (United States)

    Ahmed, Kazi Fariduddin

    A new technique, Iodine Neutron Capture Therapy (INCT) is proposed to treat hyperthyroidism in people. Present thyroid therapies, surgical removal and 131I treatment, result in hypothyroidism and, for 131I, involve protracted treatment times and excessive whole-body radiation doses. The new technique involves using a low energy neutron beam to convert a fraction of the natural iodine stored in the thyroid to radioactive 128I, which has a 24-minute half-life and decays by emitting 2.12-MeV beta particles. The beta particles are absorbed in and damage some thyroid tissue cells and consequently reduce the production and release of thyroid hormones to the blood stream. Treatment times and whole-body radiation doses are thus reduced substantially. This dissertation addresses the first of the several steps needed to obtain medical profession acceptance and regulatory approval to implement this therapy. As with other such programs, initial feasibility is established by performing experiments on suitable small mammals. Laboratory rats were used and their thyroids were exposed to the beta particles coming from small encapsulated amounts of 128I. Masses of 89.0 mg reagent-grade elemental iodine crystals have been activated in the ISU AGN-201 reactor to provide 0.033 mBq of 128I. This activity delivers 0.2 Gy to the thyroid gland of 300-g male rats having fresh thyroid tissue masses of ˜20 mg. Larger iodine masses are used to provide greater doses. The activated iodine is encapsulated to form a thin (0.16 cm 2/mg) patch that is then applied directly to the surgically exposed thyroid of an anesthetized rat. Direct neutron irradiation of a rat's thyroid was not possible due to its small size. Direct in-vivo exposure of the thyroid of the rat to the emitted radiation from 128I is allowed to continue for 2.5 hours (6 half-lives). Pre- and post-exposure blood samples are taken to quantify thyroid hormone levels. The serum T4 concentration is measured by radioimmunoassay at

  7. Workshop on neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Fairchild, R.G.; Bond, V.P. (eds.)

    1986-01-01

    Potentially optimal conditions for Neutron Capture Therapy (NCT) may soon be in hand due to the anticipated development of band-pass filtered beams relatively free of fast neutron contaminations, and of broadly applicable biomolecules for boron transport such as porphyrins and monoclonal antibodies. Consequently, a number of groups in the US are now devoting their efforts to exploring NCT for clinical application. The purpose of this Workshop was to bring these groups together to exchange views on significant problems of mutual interest, and to assure a unified and effective approach to the solutions. Several areas of preclinical investigation were deemed to be necessary before it would be possible to initiate clinical studies. As neither the monomer nor the dimer of sulfhydryl boron hydride is unequivocally preferable at this time, studies on both compounds should be continued until one is proven superior.

  8. Spectromicroscopy in Boron Neutron Capture Therapy Research

    Science.gov (United States)

    Gilbert, Benjamin; Redondo, Jose; Andres, Roger; Suda, Takashi; Neumann, Michael; Steen, Steffi; Gabel, Detlef; Mercanti, Delio; Ciotti, Teresa; Perfetti, Paolo; Margaritondo, Giorgio; de Stasio, Gelsomina

    1998-03-01

    The MEPHISTO synchrotron imaging spectromicroscope can analyse ashed cells or tissue sections to reveal the microdistribution of trace elements. MEPHISTO performs core level x-ray absorption spectroscopy with synchrotron radiation, and uses an electron optics system to provide magnified photoelectron images. An application of the MEPHISTO spectromicroscope is in boron neutron capture therapy (BNCT). BNCT is a binary cancer therapy that will selectively destroy cancer cells provided that compounds containing a boron isotope are selectively accumulated in tumor tissue. Important factors for the success of BNCT include the ability to target every cancer cell, and the distribution of boron inside the cell. To investigate the boron distribution in tissue, sections of human glioblastoma containing a BNCT compound, and stained with nickel against a protein found in the nuclei of proliferating (cancer) cells, were studied with MEPHISTO.

  9. Boron neutron capture therapy: Moving toward targeted cancer therapy

    Directory of Open Access Journals (Sweden)

    Hamid Reza Mirzaei

    2016-01-01

    Full Text Available Boron neutron capture therapy (BNCT occurs when a stable isotope, boton-10, is irradiated with low-energy thermal neutrons to yield stripped down helium-4 nuclei and lithium-7 nuclei. It is a binary therapy in the treatment of cancer in which a cytotoxic event is triggered when an atom placed in a cancer cell. Here, we provide an overview on the application of BNCT in cancer therapy as well as current preclinical and clinical evidence on the efficacy of BNCT in the treatment of melanoma, brain tumors, head and neck cancer, and thyroid cancer. Several studies have shown that BNCT is effective in patients who had been treated with a full dose of conventional radiotherapy, because of its selectivity. In addition, BNCT is dependent on the normal/tumor tissue ratio of boron distribution. Increasing evidence has shown that BNCT can be combined with different drug delivery systems to enhance the delivery of boron to cancer cells. The flexibility of BNCT to be used in combination with different tumor-targeting approaches has made this strategy a promising option for cancer therapy. This review aims to provide a state-of-the-art overview of the recent advances in the use of BNCT for targeted therapy of cancer.

  10. Research needs for neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    Key issues and questions addressed by the workshop related to optimization of Boron Neutron Capture Therapy (BNCT), in general, and to the possibility of success of the present BNCT trials at Brookhaven National Laboratory (BNL) and Massachusetts Institute of Technology (MIT), in particular. Both trials use nuclear fission reactors as neutron sources for BNCT of glioblastoma multiforme (BNL) and of deep seated melanoma (MIT). Presentations and discussions focussed on optimal boron-labeled compounds, mainly for brain tumors such as glioblastoma multiforme, and the best mode of compound delivery to the tumor. Also, optimizing neutron irradiation with dose delivery to the tumor cells and the issues of dosimetry of BNCT especially in the brain were discussed. Planning of treatment and of follow-up of patients, coordination of BNCT at various treatment sites, and the potential of delivering BNCT to various types of cancer with an appropriately tailored protocol were additional issues. The need for multicentric interdisciplinary cooperation among the different medical specialties was highlighted.

  11. Proceedings of the first international symposium on neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Fairchild, R.G.; Brownell, G.L. (eds.)

    1982-01-01

    This meeting was arranged jointly by MIT and BNL in order to illuminate progress in the synthesis and targeting of boron compounds and to evaluate and document progress in radiobiological and dosimetric aspects of neutron capture therapy. It is hoped that this meeting will facilitate transfer of information between groups working in these fields, and encourage synergistic collaboration.

  12. Theoretical and experimental physical methods of neutron-capture therapy

    Science.gov (United States)

    Borisov, G. I.

    2011-09-01

    This review is based to a substantial degree on our priority developments and research at the IR-8 reactor of the Russian Research Centre Kurchatov Institute. New theoretical and experimental methods of neutron-capture therapy are developed and applied in practice; these are: A general analytical and semi-empiric theory of neutron-capture therapy (NCT) based on classical neutron physics and its main sections (elementary theories of moderation, diffuse, reflection, and absorption of neutrons) rather than on methods of mathematical simulation. The theory is, first of all, intended for practical application by physicists, engineers, biologists, and physicians. This theory can be mastered by anyone with a higher education of almost any kind and minimal experience in operating a personal computer.

  13. Carborane derivative development for boron neutron capture therapy. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Barnum, Beverly A.; Yan Hao; Moore, Roger; Hawthorne, M. Frederick; Baum, Kurt

    1999-04-01

    Boron Neutron Capture Therapy [BNCT] is a binary method of cancer therapy based on the capture of neutrons by a boron-10 atom [{sup 10}B]. Cytotoxic {sup 7}Li nuclei and {alpha}-particles are emitted, with a range in tissue of 9 and 5 {micro}m, respectively, about one cell diameter. The major obstacle to clinically viable BNCT is the selective localization of 5-30 ppm {sup 10}B in tumor cells required for effective therapy. A promising approach to BNCT is based on hydrophilic boron-rich oligomeric phosphate diesters, or ''trailers'' that have been shown to concentrate selectively in tumor tissue. Examples of these compounds were prepared previously at high cost using an automated DNA synthesizer. Direct synthesis methods are needed for the production of gram-scale quantities for further biological evaluation. The work accomplished as a result of the collaboration between Fluorochem, Inc. and UCLA demonstrates that short oligomers containing at least five carborane units with four phosphodiester linkages can be prepared in substantial quantities. This work was accomplished by the application of standard phosphoramidite coupling chemistry.

  14. Experience of boron neutron capture therapy in Japan

    Science.gov (United States)

    Kanda, Keiji

    1997-02-01

    In Japan the boron neutron capture therapy has been applied to more than 200 patients, mostly brain tumors and some melanomas. For brain tumors, Kyoto University, Kyoto Prefectural University of Medicine, Tsukuba University and National Kagawa Children's Hospital accept patients, and for melanomas, Kobe University and Mishima Institute of Dermatological Research accept patients so far. Recently the heavy water facility of Kyoto University Reactor has been upgraded for epithermal neutron as well as thermal neutron irradiations, and for the patient treatment during the continuous operation of the KUR.

  15. The Swedish facility for boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Skoeld, K.; Capala, J. [Studsvik Medical AB (Sweden); Kierkegaard, J.; Haakansson, R. [Studsvik Nuclear AB (Sweden); Gudowska, I. [Karolinska Institute (Sweden)

    2000-10-01

    A BNCT (Boron Neutron Capture Therapy) facility has been constructed at the R2-0 reactor at Studsvik, Sweden. R2-0 is a 1 MW, open core, pool reactor. The reactor core is suspended on a movable tower and can be positioned anywhere in the pool. The BNCT facility includes two adjacent, parallel filter/moderator configurations and the reactor core is positioned in front of any of them as appropriate. One of the resulting neutron beams has been optimized for clinical irradiations with a filter/moderator system that allows easy variation of the neutron spectrum from the thermal to the epithermal energy range and with an extended collimator for convenient patient positioning. The other beam has been designed for radiobiological research and is equipped with a heavy water moderator and a large irradiation cavity with a uniform field of thermal neutrons. (author)

  16. Boron Neutron Capture Therapy for Malignant Brain Tumors

    Science.gov (United States)

    MIYATAKE, Shin-Ichi; KAWABATA, Shinji; HIRAMATSU, Ryo; KUROIWA, Toshihiko; SUZUKI, Minoru; KONDO, Natsuko; ONO, Koji

    2016-01-01

    Boron neutron capture therapy (BNCT) is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Therefore, BNCT enables the application of a high dose of particle radiation selectively to tumor cells in which boron-10 compound has been accumulated. We applied BNCT using nuclear reactors for 167 cases of malignant brain tumors, including recurrent malignant gliomas, newly diagnosed malignant gliomas, and recurrent high-grade meningiomas from January 2002 to May 2014. Here, we review the principle and history of BNCT. In addition, we introduce fluoride-18-labeled boronophenylalanine positron emission tomography and the clinical results of BNCT for the above-mentioned malignant brain tumors. Finally, we discuss the recent development of accelerators producing epithermal neutron beams. This development could provide an alternative to the current use of specially modified nuclear reactors as a neutron source, and could allow BNCT to be performed in a hospital setting. PMID:27250576

  17. Boron Neutron Capture Therapy for Malignant Brain Tumors.

    Science.gov (United States)

    Miyatake, Shin-Ichi; Kawabata, Shinji; Hiramatsu, Ryo; Kuroiwa, Toshihiko; Suzuki, Minoru; Kondo, Natsuko; Ono, Koji

    2016-07-15

    Boron neutron capture therapy (BNCT) is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Therefore, BNCT enables the application of a high dose of particle radiation selectively to tumor cells in which boron-10 compound has been accumulated. We applied BNCT using nuclear reactors for 167 cases of malignant brain tumors, including recurrent malignant gliomas, newly diagnosed malignant gliomas, and recurrent high-grade meningiomas from January 2002 to May 2014. Here, we review the principle and history of BNCT. In addition, we introduce fluoride-18-labeled boronophenylalanine positron emission tomography and the clinical results of BNCT for the above-mentioned malignant brain tumors. Finally, we discuss the recent development of accelerators producing epithermal neutron beams. This development could provide an alternative to the current use of specially modified nuclear reactors as a neutron source, and could allow BNCT to be performed in a hospital setting.

  18. The accelerator neutron source for boron neutron capture therapy

    Science.gov (United States)

    Kasatov, D.; Koshkarev, A.; Kuznetsov, A.; Makarov, A.; Ostreinov, Yu; Shchudlo, I.; Sorokin, I.; Sycheva, T.; Taskaev, S.; Zaidi, L.

    2016-11-01

    The accelerator based epithermal neutron source for Boron Neutron Capture Therapy (BNCT) is proposed, created and used in the Budker Institute of Nuclear Physics. In 2014, with the support of the Russian Science Foundation created the BNCT laboratory for the purpose to the end of 2016 get the neutron flux, suitable for BNCT. For getting 3 mA 2.3 MeV proton beam, was created a new type accelerator - tandem accelerator with vacuum isolation. On this moment, we have a stationary proton beam with 2.3 MeV and current 1.75 mA. Generation of neutrons is carried out by dropping proton beam on to lithium target as a result of threshold reaction 7Li(p,n)7Be. Established facility is a unique scientific installation. It provides a generating of neutron flux, including a monochromatic energy neutrons, gamma radiation, alpha-particles and positrons, and may be used by other research groups for carrying out scientific researches. The article describes an accelerator neutron source, presents and discusses the result of experiments and declares future plans.

  19. Treatment Planning for Accelerator-Based Boron Neutron Capture Therapy

    Science.gov (United States)

    Herrera, María S.; González, Sara J.; Minsky, Daniel M.; Kreiner, Andrés J.

    2010-08-01

    Glioblastoma multiforme and metastatic melanoma are frequent brain tumors in adults and presently still incurable diseases. Boron Neutron Capture Therapy (BNCT) is a promising alternative for this kind of pathologies. Accelerators have been proposed for BNCT as a way to circumvent the problem of siting reactors in hospitals and for their relative simplicity and lower cost among other advantages. Considerable effort is going into the development of accelerator-based BNCT neutron sources in Argentina. Epithermal neutron beams will be produced through appropriate proton-induced nuclear reactions and optimized beam shaping assemblies. Using these sources, computational dose distributions were evaluated in a real patient with diagnosed glioblastoma treated with BNCT. The simulated irradiation was delivered in order to optimize dose to the tumors within the normal tissue constraints. Using Monte Carlo radiation transport calculations, dose distributions were generated for brain, skin and tumor. Also, the dosimetry was studied by computing cumulative dose-volume histograms for volumes of interest. The results suggest acceptable skin average dose and a significant dose delivered to tumor with low average whole brain dose for irradiation times less than 60 minutes, indicating a good performance of an accelerator-based BNCT treatment.

  20. Boron neutron capture therapy in cancer: past, present and future

    Energy Technology Data Exchange (ETDEWEB)

    Pisarev, Mario A.; Dagrosa, Maria Alejandra; Juvenal, Guilermo J. [National Atomic Energy Commission, Buenos Aires (Argentina). Div. of Nuclear Biochemistry; University of Buenos Aires (Argentina). School of Medicine. Dept. of Human Biochemistry

    2007-07-15

    Undifferentiated thyroid cancer (UTC) is a very aggressive tumor with no effective treatment, since it lacks iodine uptake and does not respond to radio or chemotherapy. The prognosis of these patients is bad, due to the rapid growth of the tumor and the early development of metastasis. Boron neutron capture therapy (BNCT) is based on the selective uptake of certain boron non-radioactive compounds by a tumor, and the subsequent irradiation of the area with an appropriate neutron beam. {sup 10}B is then activated to {sup 11}B, which will immediately decay releasing alpha particles and {sup 7}Li, of high linear energy transfer (LET) and limited reach. Clinical trials are being performed in patients with glioblastoma multiform and melanoma. We have explored its possible application to UTC. Our results demonstrated that a cell line of human UTC has a selective uptake of borophenylalanine (BPA) both in vitro and after transplantation to nude mice. Treatment of mice by BNCT led to a complete control of growth and cure of 100% of the animals. Moreover dogs with spontaneous UTC also have a selective uptake of BPA. At the present we are studying the biodistribution of BPA in patients with UTC before its application in humans. (author)

  1. The three dimensional map of dose components in a head phantom for boron neutron capture therapy

    OpenAIRE

    Bavarnegin Elham; Sadremomtaz Alireza; Khalafi Hossein

    2013-01-01

    The in-phantom measurement of physical dose distribution and construction of a convenient phantom is very important for boron neutron capture therapy planning validation. In this study we have simulated a head phantom, suggested for construction in boron neutron capture therapy facilities, and calculated all relevant dose components inside of it using the Monte Carlo code MCNPX. A “generic” epithermal neutron beam with a broad neutron spectrum, similar to beams used for neutron capture ...

  2. Perflubron residua: 12 years following therapy

    Energy Technology Data Exchange (ETDEWEB)

    Servaes, Sabah; Epelman, Monica [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2009-04-15

    Partial liquid ventilation therapy utilizing perfluorocarbons has been used for patients with severe respiratory distress. Perfluorocarbons such as perflubron have been demonstrated to clear from the lungs shortly after therapy. We present a 13-year-old boy with residual perflubron in his lungs, 12 years following therapy with perflubron. The imaging features are important to recognize as these patients return for additional care and imaging. (orig.)

  3. Isodose Curves and Treatment Planning for Boron Neutron Capture Therapy.

    Science.gov (United States)

    Liu, Hungyuan B.

    The development of Boron Neutron Capture Therapy (BNCT) has been progressing in both ^{10 }B compound development and testing and neutron beam delivery. Animal tests are now in progress with several ^{10}B compounds and once the results of these animal tests are promising, patient trials can be initiated. The objective of this study is to create a treatment planning method based on the dose calculations by a Monte Carlo code of a mixed radiation field to provide linkage between phantom dosimetry and patient irradiation. The research started with an overall review of the development of BNCT. Three epithermal neutron facilities are described, including the operating Brookhaven Medical Research Reactor (BMRR) beam, the designed Missouri University Research Reactor (MURR) beam, and a designed accelerator based neutron source. The flux and dose distributions in a head model have been calculated for irradiation by these neutron beams. Different beam parameters were inter -compared for effectiveness. Dosimetric measurements in an elliptical lucite phantom and a cylindrical water phantom were made and compared to the MCNP calculations for irradiation by the BMRR beam. Repeated measurements were made and show consistent. To improve the statistical results calculated by MCNP, a neutron source plane was designed to start neutrons at the BMRR irradiation port. The source plane was used with the phantoms for dosimetric calculations. After being verified by different phantom dosimetry and in-air flux measurements at the irradiation port, the source plane was used to calculate the flux and dose distributions in the head model. A treatment planning program was created for use on a PC which uses the MCNP calculated results as input. This program calculates the thermal neutron flux and dose distributions of each component of radiation in the central coronal section of the head model for irradiation by a neutron beam. Different combinations of head orientations and irradiation

  4. Monte Carlo assessment of boron neutron capture therapy for the treatment of breast cancer

    Directory of Open Access Journals (Sweden)

    Mundy Daniel W.

    2005-01-01

    Full Text Available For a large number of women who are diagnosed with breast cancer every year the avail able treatment options are effective, though physically and mentally taxing. This work is a starting point of a study of the efficacy of boron neutron capture therapy as an alternative treatment for HER-2+ breast tumors. Using HER-2-specific monoclonal anti bodies coupled with a boron-rich oligomeric phosphate diester, it may be possible to deliver sufficient amounts of 10B to a tumor of the breast to al low for selective cell destruction via irradiation by thermal neutrons. A comprehensive computational model (MCNP for thermal neutron irradiation of the breast is described, as well as the results of calculations made using this model, in order to determine the optimum boron concentration within the tumor for an effective boron neutron capture therapy treatment, as compared with traditional X-ray radiotherapy. The results indicate that a boron concentration of 50-60 mg per gram of tumor tissue is optimal when considering treatment times, dose distributions and skin sparing. How ever these results are based upon best-guess assumptions that must be experimentally verified.

  5. Effect of diameter of nanoparticles and capture cross-section library on macroscopic dose enhancement in boron neutron capture therapy

    Science.gov (United States)

    Farhood, Bagher

    2014-01-01

    Purpose The aim of this study is evaluation of the effect of diameter of 10B nanoparticles and various neutron capture cross-section libraries on macroscopic dose enhancement in boron neutron capture therapy (BNCT). Material and methods MCNPX Monte Carlo code was used for simulation of a 252Cf source, a soft tissue phantom and a tumor containing 10B nanoparticles. Using 252Cf as a neutron source, macroscopic dose enhancement factor (MDEF) and total dose rate in tumor in the presence of 100, 200, and 500 ppm of 10B nanoparticles with 25 nm, 50 nm, and 100 nm diameters were calculated. Additionally, the effect of ENDF, JEFF, JENDL, and CENDL neutron capture cross-section libraries on MDEF was evaluated. Results There is not a linear relationship between the average MDEF value and nanoparticles’ diameter but the average MDEF grows with increased concentration of 10B nanoparticles. There is an increasing trend for average MDEF with the tumor distance. The average MDEF values were obtained the same for various neutron capture cross-section libraries. The maximum and minimum doses that effect on the total dose in tumor were neutron and secondary photon doses, respectively. Furthermore, the boron capture related dose component reduced in some extent with increase of diameter of 10B nanoparticles. Conclusions Based on the results of this study, it can be concluded that from physical point of view, various nanoparticle diameters have no dominant effect on average MDEF value in tumor. Furthermore, it is concluded that various neutron capture cross-section libraries are resulted to the same macroscopic dose enhancements. However, it is predicted that taking into account the biological effects for various nanoparticle diameters will result in different dose enhancements. PMID:25834582

  6. Tetrakis(p-Carboranylthio-Tetrafluorophenyl)Chlorin (TPFC): Application for Photodynamic Therapy and Boron Neutron Capture Therapy

    Science.gov (United States)

    HIRAMATSU, RYO; KAWABATA, SHINJI; TANAKA, HIROKI; SAKURAI, YOSHINORI; SUZUKI, MINORU; ONO, KOJI; MIYATAKE, SHIN-ICHI; KUROIWA, TOSHIHIKO; HAO, ERHONG; VICENTE, M. GRAÇA H.

    2015-01-01

    Carboranyl-containing chlorins have emerged as promising dual sensitizers for use in both photodynamic therapy (PDT) and boron neutron capture therapy (BNCT), by virtue of their known tumor affinity, low cytotoxicity in dark conditions, and their strong absorptions in the red region of the optical spectrum. Tetrakis(p-carboranylthio-tetrafluorophenyl)chlorin (TPFC) is a new synthetic carboranyl-containing chlorin of high boron content (24% by weight). To evaluate TPFC’s applicability as sensitizer for both PDT and BNCT, we performed an in vitro and in vivo study using F98 rat glioma cells and F98 rat glioma-bearing brain tumor models. For the in vivo BNCT study, we used boronophenylalanine (BPA), which is currently used in clinical BNCT studies, via intravenous administration (i.v.) and/or used TPFC via convection-enhanced delivery (CED), a method for local drug infusion directly into the brain. In the in vitro PDT study, the cell surviving fraction following laser irradiation (9 J/cm2) was 0.035 whereas in the in vitro BNCT study, the cell surviving fraction following neutron irradiation (thermal neutron = 1.73 × 1012 n/cm2) was 0.04. In the in vivo BNCT study, the median survival time following concomitant administration of BPA (i.v.) and TPFC (CED) was 42 days (95% confidence interval; 37–43 days). PMID:25546823

  7. Tetrakis(p-carboranylthio-tetrafluorophenyl)chlorin (TPFC): application for photodynamic therapy and boron neutron capture therapy.

    Science.gov (United States)

    Hiramatsu, Ryo; Kawabata, Shinji; Tanaka, Hiroki; Sakurai, Yoshinori; Suzuki, Minoru; Ono, Koji; Miyatake, Shin-ichi; Kuroiwa, Toshihiko; Hao, Erhong; Vicente, M Graça H

    2015-03-01

    Carboranyl-containing chlorins have emerged as promising dual sensitizers for use in both photodynamic therapy (PDT) and boron neutron capture therapy (BNCT), by virtue of their known tumor affinity, low cytotoxicity in dark conditions, and their strong absorptions in the red region of the optical spectrum. Tetrakis(p-carboranylthio-tetrafluorophenyl)chlorin (TPFC) is a new synthetic carboranyl-containing chlorin of high boron content (24% by weight). To evaluate TPFC's applicability as sensitizer for both PDT and BNCT, we performed an in vitro and in vivo study using F98 rat glioma cells and F98 rat glioma-bearing brain tumor models. For the in vivo BNCT study, we used boronophenylalanine (BPA), which is currently used in clinical BNCT studies, via intravenous administration (i.v.) and/or used TPFC via convection-enhanced delivery (CED), a method for local drug infusion directly into the brain. In the in vitro PDT study, the cell surviving fraction following laser irradiation (9 J/cm(2) ) was 0.035 whereas in the in vitro BNCT study, the cell surviving fraction following neutron irradiation (thermal neutron = 1.73 × 10(12) n/cm(2) ) was 0.04. In the in vivo BNCT study, the median survival time following concomitant administration of BPA (i.v.) and TPFC (CED) was 42 days (95% confidence interval; 37-43 days).

  8. On-line beam monitoring for neutron capture therapy at the MIT Research Reactor

    Science.gov (United States)

    Harling, Otto K.; Moulin, Damien J.; Chabeuf, Jean-Michel; Solares, Guido R.

    1995-08-01

    Neutron capture therapy sets new requirements on the measurement and monitoring of the radiation fields used in this new form of therapy. Beams used for neutron capture therapy are comprised of mixed radiation fields which include slow, epithermal, and fast neutrons, as well as gamma rays. A computer-based beam monitoring system for epithermal or thermal neutron capture therapy is described. This system provides accurate, sensitive, and rapid on-line readout and recording of the various beam components. Readout of fluxes, fluences, and corresponding doses in the target are provided in color coded graphic analog as well as numerical form on the computer monitors. Variations in neutron spectrum or spatial distribution of the beam can be rapidly diagnosed with the aid of the monitor readout. Redundancy of fluence measurement is provided by an independent system using scalers and timers and by utilizing reactor power measuring instruments.

  9. Fission reactor neutron sources for neutron capture therapy--a critical review.

    Science.gov (United States)

    Harling, Otto K; Riley, Kent J

    2003-01-01

    The status of fission reactor-based neutron beams for neutron capture therapy (NCT) is reviewed critically. Epithermal neutron beams, which are favored for treatment of deep-seated tumors, have been constructed or are under construction at a number of reactors worldwide. Some of the most recently constructed epithermal neutron beams approach the theoretical optimum for beam purity. Of these higher quality beams, at least one is suitable for use in high through-put routine therapy. It is concluded that reactor-based epithermal neutron beams with near optimum characteristics are currently available and more can be constructed at existing reactors. Suitable reactors include relatively low power reactors using the core directly as a source of neutrons or a fission converter if core neutrons are difficult to access. Thermal neutron beams for NCT studies with small animals or for shallow tumor treatments, with near optimum properties have been available at reactors for many years. Additional high quality thermal beams can also be constructed at existing reactors or at new, small reactors. Furthermore, it should be possible to design and construct new low power reactors specifically for NCT, which meet all requirements for routine therapy and which are based on proven and highly safe reactor technology.

  10. A case of radiation-induced osteosarcoma treated effectively by boron neutron capture therapy.

    Science.gov (United States)

    Futamura, Gen; Kawabata, Shinji; Siba, Hiroyuki; Kuroiwa, Toshihiko; Suzuki, Minoru; Kondo, Natsuko; Ono, Koji; Sakurai, Yoshinori; Tanaka, Minoru; Todo, Tomoki; Miyatake, Shin-Ichi

    2014-11-04

    We treated a 54-year-old Japanese female with a recurrent radiation-induced osteosarcoma arising from left occipital skull, by reactor-based boron neutron capture therapy (BNCT). Her tumor grew rapidly with subcutaneous and epidural extension. She eventually could not walk because of cerebellar ataxia. The tumor was inoperable and radioresistant. BNCT showed a marked initial therapeutic effect: the subcutaneous/epidural tumor reduced without radiation damage of the scalp except hair loss and the patient could walk again only 3 weeks after BNCT. BNCT seems to be a safe and very effective modality in the management of radiation-induced osteosarcomas that are not eligible for operation and other treatment modalities.

  11. The Boron Neutron Capture Therapy (BNCT) Project at the TRIGA Reactor in Mainz, Germany

    Energy Technology Data Exchange (ETDEWEB)

    Hampel, G.; Grunewald, C.; Schutz, C.; Schmitz, T.; Kratz, J.V. [Nuclear Chemistry, University of Mainz, D-55099 Mainz (Germany); Brochhausen, C.; Kirkpatrick, J. [Department of Pathology, University of Mainz, D-55099 Mainz (Germany); Bortulussi, S.; Altieri, S. [Department of Nuclear and Theoretical Physics University of Pavia, Pavia (Italy); National Institute of Nuclear Physics (INFN) Pavia Section, Pavia (Italy); Kudejova, P. [Forschungs-Neutronenquelle Heinz Maier-Leibnitz (FRM II), Technische Universitaet Muenchen, D-85748 Garching (Germany); Appelman, K.; Moss, R. [Joint Research Centre (JRC) of the European Commission, NL-1755 ZG Petten (Netherlands); Bassler, N. [University of Aarhus, Norde Ringade, DK-8000, Aarhus C (Denmark); Blaickner, M.; Ziegner, M. [Molecular Medicine, Health and Environment Department, AIT Austrian Institute of Technology GmbH (Austria); Sharpe, P.; Palmans, H. [National Physical Laboratory, Teddington TW11 0LW, Middlesex (United Kingdom); Otto, G. [Department of Hepatobiliary, Pancreatic and Transplantation Surgery, University of Mainz, D-55099 Mainz (Germany)

    2011-07-01

    The thermal column of the TRIGA reactor in Mainz is being used very effectively for medical and biological applications. The BNCT (boron neutron capture therapy) project at the University of Mainz is focussed on the treatment of liver tumours, similar to the work performed in Pavia (Italy) a few years ago, where patients with liver metastases were treated by combining BNCT with auto-transplantation of the organ. Here, in Mainz, a preclinical trial has been started on patients suffering from liver metastases of colorectal carcinoma. In vitro experiments and the first animal tests have also been initiated to investigate radiobiological effects of radiation generated during BNCT. For both experiments and the treatment, a reliable dosimetry system is necessary. From work elsewhere, the use of alanine detectors appears to be an appropriate dosimetry technique. (author)

  12. Gadolinium as an element for neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Brugger, R.M.; Liu, H.B.; Laster, B.H.; Gordon, C.R.; Greenberg, D.D.; Warkentien, L.S.

    1992-01-01

    At BNL, preparations are being made to test in vitro compounds containing Gd and compare their response to the response of GD-DTPA to determine if one or several compounds can be located that enter the cells and enhance the Auger effect. Two similar rotators with positions for cell vials that have been constructed for these tests. The first rotator is made of only paraffin which simulates healthy tissue and provides control curves. The second rotator has 135 ppM of Gd-157 in the paraffin to simulate a Gd loaded tumor. Cells are irradiated in vials in the paraffin rotator and in the Gd-paraffin rotator at the epithermal beam of the Brookhaven Medical Research Reactor (BMRR). This produces an irradiation similar to what a patient would receive In an actual treatment. A combination of irradiations are made with both rotators; with no Gd compound or IdUrd In the cell media, with only Gd compound in the cell media and with both Gd compound and IdUrd in the cell media. The first set shows the effects of gamma rays from the H(n,gamma) reaction and the prompt gamma rays from capture of neutrons by Gd. The second set shows if there is any effect of Gd being in the cell media or inside the cells, i.e., an Auger effect. The third set shows the effect of enhancement by the IdUrd produced by the gamma rays from neutrons captured by either H or Gd. The fourth set combines all of the reactions and enhancements. Preliminary calculations and physical measurements of the doses that the cells will receive In these rotators have been made.

  13. Gadolinium as an element for neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Brugger, R.M.; Liu, H.B.; Laster, B.H.; Gordon, C.R.; Greenberg, D.D.; Warkentien, L.S.

    1992-12-31

    At BNL, preparations are being made to test in vitro compounds containing Gd and compare their response to the response of GD-DTPA to determine if one or several compounds can be located that enter the cells and enhance the Auger effect. Two similar rotators with positions for cell vials that have been constructed for these tests. The first rotator is made of only paraffin which simulates healthy tissue and provides control curves. The second rotator has 135 ppM of Gd-157 in the paraffin to simulate a Gd loaded tumor. Cells are irradiated in vials in the paraffin rotator and in the Gd-paraffin rotator at the epithermal beam of the Brookhaven Medical Research Reactor (BMRR). This produces an irradiation similar to what a patient would receive In an actual treatment. A combination of irradiations are made with both rotators; with no Gd compound or IdUrd In the cell media, with only Gd compound in the cell media and with both Gd compound and IdUrd in the cell media. The first set shows the effects of gamma rays from the H(n,gamma) reaction and the prompt gamma rays from capture of neutrons by Gd. The second set shows if there is any effect of Gd being in the cell media or inside the cells, i.e., an Auger effect. The third set shows the effect of enhancement by the IdUrd produced by the gamma rays from neutrons captured by either H or Gd. The fourth set combines all of the reactions and enhancements. Preliminary calculations and physical measurements of the doses that the cells will receive In these rotators have been made.

  14. Neutron capture therapy of ocular melanoma: dosimetry and microdosimetry approaches; Therapie par capture de neutrons des melanomes oculaires: approches dosimetrique et microdosimetrique

    Energy Technology Data Exchange (ETDEWEB)

    Pignol, J.P.; Methlin, G. [Centre Paul Strauss, 67 - Strasbourg (France); Abbe, J.C. [Strasbourg-1 Univ., 67 (France). Centre de Recherches Nucleaires; Stampfler, A. [Strasbourg-1 Univ., 67 (France); Lefebvre, O. [Faculte de Medecine, 67 - Strasbourg (France); Sahel, J. [Centre Hospitalier Universitaire, 67 - Strasbourg (France)

    1994-06-01

    Neutron capture therapy (NCT) aims at destroying cancerous cells with the {alpha} and {sup 7}Li particles produced by the neutron capture reaction on {sup 10}B. This note reports on the study of the boron distribution in tissues on an animal model (nude mice) xenografted with a human ocular melanoma after an i.p.injection of 2g/kg of {sup 10}B-BPA and in cells cultured in the presence of 530 {mu}mol/l of {sup 10}B-BPA. A concentration of 64 ppm of {sup 10}B in the active part of the tumour with a ratio of concentrations versus the skin of 3.7 are observed. Investigations on cells reveal the presence of boron in the cytoplasm. The biological, dosimetric and microdosimetric consequences of these findings are discussed. (authors). 15 refs., 2 tabs., 2 figs.

  15. Proceedings of workshop on 'boron science and boron neutron capture therapy'

    Energy Technology Data Exchange (ETDEWEB)

    Kitaoka, Y. [ed.

    1998-12-01

    This volume contains the abstracts and programs of the 8th (1996), 9th (1997) and 10th (1998) of the workshop on 'the Boron Science and Boron Neutron Capture Therapy' and the recent progress reports especially subscribed. The 11 of the presented papers are indexed individually. (J.P.N.)

  16. The three dimensional map of dose components in a head phantom for boron neutron capture therapy

    Directory of Open Access Journals (Sweden)

    Bavarnegin Elham

    2013-01-01

    Full Text Available The in-phantom measurement of physical dose distribution and construction of a convenient phantom is very important for boron neutron capture therapy planning validation. In this study we have simulated a head phantom, suggested for construction in boron neutron capture therapy facilities, and calculated all relevant dose components inside of it using the Monte Carlo code MCNPX. A “generic” epithermal neutron beam with a broad neutron spectrum, similar to beams used for neutron capture therapy clinical trials, was used. The calculated distributions of all relevant dose components in brain tissue equivalent were compared with those in water. The results show that water is a suitable dosimetry material and that the simulated head phantom is a suitable design for producing accurate three-dimensional maps of dose components at enough points inside of the phantom for boron neutron capture therapy dosimetry measurements and the use of these dose maps in beam development and benchmarking of computer-based treatment codes.

  17. The Boron Neutron Capture Therapy (BNCT) Project at the TRIGA Reactor in Mainz, Germany

    DEFF Research Database (Denmark)

    Hampel, G.; Grunewald, C.; Schütz, C.

    2011-01-01

    The thermal column of the TRIGA reactor in Mainz is being used very effectively for medical and biological applications. The BNCT (boron neutron capture therapy) project at the University of Mainz is focussed on the treatment of liver tumours, similar to the work performed at Pavia (Italy) a few...

  18. Monte Carlo based dosimetry for neutron capture therapy of brain tumors

    Science.gov (United States)

    Zaidi, Lilia; Belgaid, Mohamed; Khelifi, Rachid

    2016-11-01

    Boron Neutron Capture Therapy (BNCT) is a biologically targeted, radiation therapy for cancer which combines neutron irradiation with a tumor targeting agent labeled with a boron10 having a high thermal neutron capture cross section. The tumor area is subjected to the neutron irradiation. After a thermal neutron capture, the excited 11B nucleus fissions into an alpha particle and lithium recoil nucleus. The high Linear Energy Transfer (LET) emitted particles deposit their energy in a range of about 10μm, which is of the same order of cell diameter [1], at the same time other reactions due to neutron activation with body component are produced. In-phantom measurement of physical dose distribution is very important for BNCT planning validation. Determination of total absorbed dose requires complex calculations which were carried out using the Monte Carlo MCNP code [2].

  19. Basic and clinical study of boron neutron capture therapy for malignant brain tumor

    Energy Technology Data Exchange (ETDEWEB)

    Nose, Tadao; Matsumura, Akira; Nakai, Kei; Nakagawa, Kunio; Yoshii, Yoshihiko [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine; Shibata, Yasushi; Yamamoto, Tetsuya; Hayakawa, Yoshinori; Yamada, Takashi

    1998-01-01

    Rat malignant cells (9L glioma cell) were exposed to neutron radiation after culturing with boron compounds; BSH and STA-BX909, and cell growing ability after the exposure was determined by colony forming assay. The effects of in vivo radiation were examined by measuring neutron flux levels in rat brain and skin aiming to use neutron radiation in clinical study. STA-BX909 was found to show a dose-dependent cell toxicity, which was higher than that of BSH. The radiation induced G2/M block in 9L-glioma cells and their cell cycles recovered thereafter in low-dose radiated cells, but high-dose radiated cells became aneuploidy. Furthermore, boron neutron capture therapy (BNCT) was applied in two patients, 41-year old woman with glioma grade 3 recurred and 45-year old man with glioblastoma multiforme. The former died from systemic deterioration due to ileus, but BNCT was made only one time although conventional radiotherapy is carried out for a relatively long period. Therefore, BNCT was thought to be beneficial from an aspect of `quality of life` and the effects to repress a recurrence of cancer also seemed larger than the conventional one. (M.N.)

  20. Implications for clinical treatment from the micrometer site dosimetric calculations in boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Nichols, Trent L. [Department of Physics and Astronomy, University of Tennessee, Knoxville, TN 37901 (United States)], E-mail: tnichol2@utk.edu; Kabalka, George W. [Department of Chemistry, University of Tennessee, Knoxville, TN 37901 (United States); Miller, Laurence F. [Department of Nuclear and Radiological Engineering, University of Tennessee, Knoxville, TN 37901 (United States); McCormack, Michael T. [Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN 37920 (United States); Johnson, Andrew [Rush University Medical Center, Chicago, IL 60612 (United States)

    2009-07-15

    Boron neutron capture therapy has now been used for several malignancies. Most clinical trials have addressed its use for the treatment of glioblastoma multiforme. A few trials have focused on the treatment of malignant melanoma with brain metastases. Trial results for the treatment of glioblastoma multiforme have been encouraging, but have not achieved the success anticipated. Results of trials for the treatment of malignant melanoma have been very promising, though with too few patients for conclusions to be drawn. Subsequent to these trials, regimens for undifferentiated thyroid carcinoma, hepatic metastases from adenocarcinoma of the colon, and head and neck malignancies have been developed. These tumors have also responded well to boron neutron capture therapy. Glioblastoma is an infiltrative tumor with distant individual tumor cells that might create a mechanism for therapeutic failure though recurrences are often local. The microdosimetry of boron neutron capture therapy can provide an explanation for this observation. Codes written to examine the micrometer scale energy deposition in boron neutron capture therapy have been used to explore the effects of near neighbor cells. Near neighbor cells can contribute a significantly increased dose depending on the geometric relationships. Different geometries demonstrate that tumors which grow by direct extension have a greater near neighbor effect, whereas infiltrative tumors lose this near neighbor dose which can be a significant decrease in dose to the cells that do not achieve optimal boron loading. This understanding helps to explain prior trial results and implies that tumors with small, closely packed cells that grow by direct extension will be the most amenable to boron neutron capture therapy.

  1. Dose monitoring for boron neutron capture therapy using a reactor-based epithermal neutron beam

    Science.gov (United States)

    Raaijmakers, C. P. J.; Nottelman, E. L.; Konijnenberg, M. W.; Mijnheer, B. J.

    1996-12-01

    The aims of this study were (i) to determine the variation with time of the relevant beam parameters of a clinical reactor-based epithermal neutron beam for boron neutron capture therapy (BNCT) and (ii) to test a monitoring system for its applicability to monitor the dose delivered to the dose specification point in a patient treated with BNCT. For this purpose two fission chambers covered with Cd and two GM counters were positioned in the beam-shaping collimator assembly of the epithermal neutron beam. The monitor count rates were compared with in-phantom reference measurements of the thermal neutron fluence rate, the gamma-ray dose rate and the fast neutron dose rate, at a constant reactor power, over a period of 2 years. Differences in beam output, defined as the thermal neutron fluence rate at 2 cm depth in a phantom, of up to 15% were observed between various reactor cycles. A decrease in beam output of about 5% was observed in each reactor cycle. An unacceptable decrease of 50% in beam output due to malfunctioning of the beam filter assembly was detected. For safe and accurate treatment of patients, on-line monitoring of the beam is essential. Using the calibrated monitor system, the standard uncertainty in the total dose at depth due to variations with time of the beam output parameters has been reduced to a clinically acceptable value of 1% (one standard deviation).

  2. A state-of-the-art epithermal neutron irradiation facility for neutron capture therapy

    Science.gov (United States)

    Riley, K. J.; Binns, P. J.; Harling, O. K.

    2004-08-01

    At the Massachusetts Institute of Technology (MIT) the first fission converter-based epithermal neutron beam (FCB) has proven suitable for use in clinical trials of boron neutron capture therapy (BNCT). The modern facility provides a high intensity beam together with low levels of contamination that is ideally suited for use with future, more selective boron delivery agents. Prescriptions for normal tissue tolerance doses consist of 2 or 3 fields lasting less than 10 min each with the currently available beam intensity, that are administered with an automated beam monitoring and control system to help ensure safety of the patient and staff alike. A quality assurance program ensures proper functioning of all instrumentation and safety interlocks as well as constancy of beam output relative to routine calibrations. Beam line shutters and the medical room walls provide sufficient shielding to enable access and use of the facility without affecting other experiments or normal operation of the multipurpose research reactor at MIT. Medical expertise and a large population in the greater Boston area are situated conveniently close to the university, which operates the research reactor 24 h a day for approximately 300 days per year. The operational characteristics of the facility closely match those established for conventional radiotherapy, which together with a near optimum beam performance ensure that the FCB is capable of determining whether the radiobiological promise of NCT can be realized in routine practice.

  3. Boron neutron capture therapy outcomes for advanced or recurrent head and neck cancer

    Science.gov (United States)

    Suzuki, Minoru; Kato, Ituro; Aihara, Teruhito; Hiratsuka, Junichi; Yoshimura, Kenichi; Niimi, Miyuki; Kimura, Yoshihiro; Ariyoshi, Yasunori; Haginomori, Shin-ichi; Sakurai, Yoshinori; Kinashi, Yuko; Masunaga, Shin-ichiro; Fukushima, Masanori; Ono, Koji; Maruhashi, Akira

    2014-01-01

    We retrospectively review outcomes of applying boron neutron capture therapy (BNCT) to unresectable advanced or recurrent head and neck cancers. Patients who were treated with BNCT for either local recurrent or newly diagnosed unresectable head or neck cancers between December 2001 and September 2007 were included. Clinicopathological characteristics and clinical outcomes were retrieved from hospital records. Either a combination of borocaptate sodium and boronophenylalanine (BPA) or BPA alone were used as boron compounds. In all the treatment cases, the dose constraint was set to deliver a dose <10–12 Gy-eq to the skin or oral mucosa. There was a patient cohort of 62, with a median follow-up of 18.7 months (range, 0.7–40.8). A total of 87 BNCT procedures were performed. The overall response rate was 58% within 6 months after BNCT. The median survival time was 10.1 months from the time of BNCT. The 1- and 2-year overall survival (OS) rates were 43.1% and 24.2%, respectively. The major acute Grade 3 or 4 toxicities were hyperamylasemia (38.6%), fatigue (6.5%), mucositis/stomatitis (9.7%) and pain (9.7%), all of which were manageable. Three patients died of treatment-related toxicity. Three patients experienced carotid artery hemorrhage, two of whom had coexistent infection of the carotid artery. This study confirmed the feasibility of our dose-estimation method and that controlled trials are warranted. PMID:23955053

  4. Effectiveness of boron neutron capture therapy for recurrent head and neck malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Itsuro [Department of Oral and Maxillofacial Surgery, II Osaka University, Graduate School of Dentistry, Osaka (Japan)], E-mail: katoitsu@dent.osaka-u.ac.jp; Fujita, Yusei [Department of Oral and Maxillofacial Surgery, II Osaka University, Graduate School of Dentistry, Osaka (Japan); Maruhashi, Akira [Radiation Oncology Research Laboratory, Research Reactor Institut, Kyoto University, Osaka (Japan); Kumada, Hiroaki [Japan Atomic Energy Agency, Tokai Research and Development Center, Ibaraki (Japan); Ohmae, Masatoshi [Department of Oral and Maxillofacial Surgery, Izimisano Municipal Hospital, Rinku General Hospital, Izumisano, Osaka (Japan); Kirihata, Mitsunori [Graduate School of Environment and Life Science, Osaka prefectural University, Osaka (Japan); Imahori, Yoshio [Department of Neurosurgery, Kyoto Prefectural University, Kyoto (Japan); CEO of Cancer Intelligence Care Systems, Inc., Tokyo (Japan); Suzuki, Minoru [Radiation Oncology Research Laboratory, Research Reactor Institut, Kyoto University, Osaka (Japan); Sakrai, Yoshinori [Graduate School of Medicine, Sapporo Medical University of Medicine, Hokkaido (Japan); Sumi, Tetsuro; Iwai, Soichi; Nakazawa, Mitsuhiro [Department of Oral and Maxillofacial Surgery, II Osaka University, Graduate School of Dentistry, Osaka (Japan); Murata, Isao; Miyamaru, Hiroyuki [Division of Electrical, Electronic and Information Engineering, Graduate School of Engineering, Osaka University (Japan); Ono, Koji [Radiation Oncology Research Laboratory, Research Reactor Institut, Kyoto University, Osaka (Japan)

    2009-07-15

    It is necessary to explore new treatments for recurrent head and neck malignancies (HNM) to avoid severe impairment of oro-facial structures and functions. Boron neutron capture therapy (BNCT) is tumor-cell targeted radiotherapy that has significant superiority over conventional radiotherapies in principle. We have treated with BNCT 42 times for 26 patients (19 squamous cell carcinomas (SCC), 4 salivary gland carcinomas and 3 sarcomas) with a recurrent and far advanced HNM since 2001. Results of (1) {sup 10}B concentration of tumor/normal tissue ratios (T/N ratio) of FBPA-PET studies were SCC: 1.8-5.7, sarcoma: 2.5-4.0, parotid tumor: 2.5-3.7. (2) Therapeutic effects were CR: 12 cases, PR: 10 cases, PD: 3 cases NE (not evaluated): 1 case. Response rate was 85%. (3) Improvement of QOL such as a relief of severe pain, bleeding, and exudates at the local lesion, improvement of PS, disappearance of ulceration, covered with normal skin and preserved oral and maxillofacial functions and tissues. (4) Survival periods after BNCT were 1-72 months (mean: 13.6 months). Six-year survival rate was 24% by Kaplan-Meier analysis. (5) Adverse-events were transient mucositis and alopecia in most of the cases; three osteomyelitis and one brain necrosis were recognized. These results indicate that BNCT represents a new and promising treatment approach for advanced HNM.

  5. A theoretical model for the production of Ac-225 for cancer therapy by neutron capture transmutation of Ra-226.

    Science.gov (United States)

    Melville, G; Melville, P

    2013-02-01

    Radium needles that were once implanted into tumours as a cancer treatment are now obsolete and constitute a radioactive waste problem, as their half-life is 1600 years. We are investigating the reduction of radium by transmutation by bombarding Ra-226 with high-energy neutrons from a neutron source to produce Ra-225 and hence Ac-225, which can be used as a generator to produce Bi-213 for use in 'Targeted Alpha Therapy' for cancer. This paper examines the possibility of producing Ac-225 by neutron capture using a theoretical model in which neutron energy is convoluted with the corresponding neutron cross sections of Ra-226. The total integrated yield can then be obtained. This study shows that an intense beam of high-energy neutrons could initiate neutron capture on Ra-226 to produce Ra-225 and hence practical amounts of Ac-225 and a useful reduction of Ra-226.

  6. Design for an accelerator-based orthogonal epithermal neutron beam for boron neutron capture therapy.

    Science.gov (United States)

    Allen, D A; Beynon, T D; Green, S

    1999-01-01

    This paper is concerned with the proposed Birmingham accelerator-based epithermal neutron beam for boron neutron capture therapy (BNCT). In particular, the option of producing a therapy beam at an orthogonal direction to the incoming protons is considered. Monte Carlo radiation transport simulations, both with and without a head phantom, have shown that an orthogonal beam geometry is not only acceptable but is indeed beneficial, in terms of a lower mean neutron energy and an enhanced therapeutic ratio for the same useful neutron fluence in the therapy beam. Typical treatment times for various beam options have been calculated, and range from 20 to 48 min with a 5 mA beam of 2.8 MeV protons, if the maximum photon-equivalent dose delivered to healthy tissue is to be 12.6 Gy Eq. The effects of proton beam diameter upon the therapy beam parameters have also been considered.

  7. Background of photon-capture therapy principle of malignant cancer treatment

    Directory of Open Access Journals (Sweden)

    Sheino I.N.

    2013-12-01

    Full Text Available Aim: the study of the physical effect of the local dose increasing in biological tissue at the gadolinium-containing drug under the influence of X-ray radiation. Material and Methods. Experimental and three independent numerical methods are obtained distribution of the absorbed dose in tissue-equivalent phantom containing a model of the tumor with a given concentration of gadolinium. Results. The presence of a gadolinium-containing drug in the biological tissue (1% Gd by weight leads to a local increase of an absorbed dose up to 2 times under the influence of X-ray radiation. The difference in the results obtained calculated and experimental methods does not exceed 12%. Conclusion. The results of the study confirmed the basic theoretical background photon capture therapy, as well as the legal use of methods of mathematic modeling of the process of forming radiation in biological tissue, necessary for dosimetric photon capture therapy planning.

  8. In-phantom dose mapping in neutron capture therapy by means of solid state detectors

    Science.gov (United States)

    Baccaro, S.; Cemmi, A.; Colombi, C.; Fiocca, M.; Gambarini, G.; Lietti, B.; Rosi, G.

    2004-01-01

    A method has been developed, based on thermoluminescent dosimeters and alanine, aimed at measuring the absorbed dose in tissue-equivalent phantoms exposed to an epithermal neutron beam suitable for neutron capture therapy (NCT), separating the contributions due to the various secondary radiations generated by neutrons. Exposures have been made at the TAPIRO nuclear reactor (ENEA, Italy), in the epithermal column properly designed and set up for experiments on boron NCT.

  9. NCTPlan application for neutron capture therapy dosimetric planning at MEPhI nuclear research reactor.

    Science.gov (United States)

    Elyutina, A S; Kiger, W S; Portnov, A A

    2011-12-01

    The results of modeling of two therapeutic beams HEC-1 and HEC-4 at the NRNU "MEPhI" research nuclear reactor exploitable for preclinical treatments are reported. The exact models of the beams are constructed as an input to the NCTPlan code used for planning Neutron Capture Therapy (NCT) procedure. The computations are purposed to improve the accuracy of prediction of a dose absorbed in tissue with the account of all components of radiation.

  10. Investigation of Isfahan miniature neutron source reactor (MNSR) for boron neutron capture therapy by MCNP simulation

    OpenAIRE

    S. Z. Kalantari; H Tavakoli; Nami, M.

    2015-01-01

    One of the important neutron sources for Boron Neutron Capture Therapy (BNCT) is a nuclear reactor. It needs a high flux of epithermal neutrons. The optimum conditions of the neutron spectra for BNCT are provided by the International Atomic Energy Agency (IAEA). In this paper, Miniature Neutron Source Reactor (MNSR) as a neutron source for BNCT was investigated. For this purpose, we designed a Beam Shaping Assembly (BSA) for the reactor and the neutron transport from the core of the reactor t...

  11. Beam neutron energy optimization for boron neutron capture therapy using Monte Carlo method

    OpenAIRE

    Ali Pazirandeh; Elham Shekarian

    2006-01-01

     In last two decades the optimal neutron energy for the treatment of deep seated tumors in boron neutron capture therapy in view of neutron physics and chemical compounds of boron carrier has been under thorough study. Although neutron absorption cross section of boron is high (3836b), the treatment of deep seated tumors such as gliobelastoma multiform (GBM) requires beam of neutrons of higher energy that can penetrate deeply into the brain and thermalize in the proximity of the tumor. Dosage...

  12. Power Burst Facility/Boron Neutron Capture Therapy Program for cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Ackermann, A.L. (ed.); Dorn, R.V. III.

    1990-08-01

    This report discusses monthly progress in the Power Boron Facility/Boron Neutron Capture Therapy (PBF/BNCT) Program for Cancer Treatment. Highlights of the PBF/BNCT Program during August 1990 include progress within the areas of: Gross Boron Analysis in Tissue, Blood, and Urine, boron microscopic (subcellular) analytical development, noninvasive boron quantitative determination, analytical radiation transport and interaction modeling for BNCT, large animal model studies, neutron source and facility preparation, administration and common support and PBF operations.

  13. Design of a boron neutron capture enhanced fast neutron therapy assembly

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Zhonglu [Georgia Inst. of Technology, Atlanta, GA (United States)

    2006-12-01

    The use of boron neutron capture to boost tumor dose in fast neutron therapy has been investigated at several fast neutron therapy centers worldwide. This treatment is termed boron neutron capture enhanced fast neutron therapy (BNCEFNT). It is a combination of boron neutron capture therapy (BNCT) and fast neutron therapy (FNT). It is believed that BNCEFNT may be useful in the treatment of some radioresistant brain tumors, such as glioblastoma multiform (GBM). A boron neutron capture enhanced fast neutron therapy assembly has been designed for the Fermilab Neutron Therapy Facility (NTF). This assembly uses a tungsten filter and collimator near the patient's head, with a graphite reflector surrounding the head to significantly increase the dose due to boron neutron capture reactions. The assembly was designed using Monte Carlo radiation transport code MCNP version 5 for a standard 20x20 cm2 treatment beam. The calculated boron dose enhancement at 5.7-cm depth in a water-filled head phantom in the assembly with a 5x5 cm2 collimation was 21.9% per 100-ppm 10B for a 5.0-cm tungsten filter and 29.8% for a 8.5-cm tungsten filter. The corresponding dose rate for the 5.0-cm and 8.5-cm thick filters were 0.221 and 0.127 Gy/min, respectively; about 48.5% and 27.9% of the dose rate of the standard 10x10 cm2 fast neutron treatment beam. To validate the design calculations, a simplified BNCEFNT assembly was built using four lead bricks to form a 5x5 cm2 collimator. Five 1.0-cm thick 20x20 cm2 tungsten plates were used to obtain different filter thicknesses and graphite bricks/blocks were used to form a reflector. Measurements of the dose enhancement of the simplified assembly in a water-filled head phantom were performed using a pair of tissue-equivalent ion chambers. One of the ion chambers is loaded with 1000-ppm natural boron (184-ppm 10B) to measure dose due to boron neutron capture. The

  14. {sup 33}S for Neutron Capture Therapy: Nuclear Data for Monte Carlo Calculations

    Energy Technology Data Exchange (ETDEWEB)

    Porras, I., E-mail: porras@ugr.es [Departamento de Física Atómica, Molecular y Nuclear, Facultad de Ciencias, Universidad de Granada, E-18071 Granada (Spain); Sabaté-Gilarte, M.; Praena, J.; Quesada, J.M. [Departamento de Física Atómica, Molecular y Nuclear, Facultad de Física, Universidad de Sevilla, E-41012 Sevilla (Spain); Esquinas, P.L. [Departament of Physics and Astronomy, University of British Columbia, Vancouver, BC (Canada)

    2014-06-15

    A study of the nuclear data required for the Monte Carlo simulation of boron neutron capture therapy including the {sup 33}S isotope as an enhancer of the dose at small depths has been performed. In particular, the controversy on the available data for the {sup 33}S(n, α) cross section will be shown, which motivates new measurements. In addition to this, kerma factors for the main components of tissue are calculated with the use of fitting functions. Finally, we have applied these data to a potential neutron capture treatment with boron and sulfur addition to tissue in which part of the hydrogen atoms are replaced by deuterium, which improves the procedure.

  15. Boron neutron capture therapy of malignant brain tumors at the Brookhaven Medical Research Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Joel, D.D.; Coderre, J.A.; Chanana, A.D. [Brookhaven National Lab., Upton, NY (United States). Medical Dept.

    1996-12-31

    Boron neutron capture therapy (BNCT) is a bimodal form of radiation therapy for cancer. The first component of this treatment is the preferential localization of the stable isotope {sup 10}B in tumor cells by targeting with boronated compounds. The tumor and surrounding tissue is then irradiated with a neutron beam resulting in thermal neutron/{sup 10}B reactions ({sup 10}B(n,{alpha}){sup 7}Li) resulting in the production of localized high LET radiation from alpha and {sup 7}Li particles. These products of the neutron capture reaction are very damaging to cells, but of short range so that the majority of the ionizing energy released is microscopically confined to the vicinity of the boron-containing compound. In principal it should be possible with BNCT to selectively destroy small nests or even single cancer cells located within normal tissue. It follows that the major improvements in this form of radiation therapy are going to come largely from the development of boron compounds with greater tumor selectivity, although there will certainly be advances made in neutron beam quality as well as the possible development of alternative sources of neutron beams, particularly accelerator-based epithermal neutron beams.

  16. A suggestion for B-10 imaging during boron neutron capture therapy

    CERN Document Server

    Cortesi, M

    2007-01-01

    Selective accumulation of B-10 compound in tumour tissue is a fundamental condition for the achievement of BNCT (Boron Neutron Capture Therapy), since the effectiveness of therapy irradiation derives just from neutron capture reaction of B-10. Hence, the determination of the B-10 concentration ratio, between tumour and healthy tissue, and a control of this ratio, during the therapy, are essential to optimise the effectiveness of the BNCT, which it is known to be based on the selective uptake of B-10 compound. In this work, experimental methods are proposed and evaluated for the determination in vivo of B-10 compound in biological samples, in particular based on neutron radiography and gammaray spectroscopy by telescopic system. Measures and Monte Carlo calculations have been performed to investigate the possibility of executing imaging of the 10B distribution, both by radiography with thermal neutrons, using 6LiF/ZnS:Ag scintillator screen and a CCD camera, and by spectroscopy, based on the revelation of gamm...

  17. Boron containing magnetic nanoparticles for neutron capture therapy--an innovative approach for specifically targeting tumors.

    Science.gov (United States)

    Tietze, Rainer; Unterweger, Harald; Dürr, Stephan; Lyer, Stefan; Canella, Lea; Kudejova, Petra; Wagner, Franz M; Petry, Winfried; Taccardi, Nicola; Alexiou, Christoph

    2015-12-01

    The selective delivery of (10)B into the tumor tissue remains to be further improved for successful and reliable Boron Neutron Capture Therapy applications. Magnetic Drug Targeting using intraarterially administered superparamagnetic nanoparticles and external magnetic fields already exhibited convincing results in terms of highly efficient and selective drug deposition. Using the same technique for the targeted (10)B delivery is a promising new approach. Here, systematic irradiation experiments of phantom cubes containing different concentrations of boron and nanoparticles as well as varying three-dimensional arrangements have been performed.

  18. Dose estimation for internal organs during boron neutron capture therapy for body-trunk tumors.

    Science.gov (United States)

    Sakurai, Y; Tanaka, H; Suzuki, M; Masunaga, S; Kinashi, Y; Kondo, N; Ono, K; Maruhashi, A

    2014-06-01

    Radiation doses during boron neutron capture therapy for body-trunk tumors were estimated for various internal organs, using data from patients treated at Kyoto University Research Reactor Institute. Dose-volume histograms were constructed for tissues of the lung, liver, kidney, pancreas, and bowel. For pleural mesothelioma, the target total dose to the normal lung tissues on the diseased side is 5Gy-Eq in average for the whole lung. It was confirmed that the dose to the liver should be carefully considered in cases of right lung disease.

  19. Single photon image from position emission tomography with insertable collimator for boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Joo Young; Yoo, Do Kun; Suh, Tae Suk [Dept. of Biomedical Engineering and Research Institute of Biomedical Engineering, College of Medicine, Catholic University of Korea, Seoul (Korea, Republic of); Hong, Key Jo [Molecular Imaging Program at Stanford (MIPS), Dept. of Radiology, Stanford University, Stanford (United States)

    2014-04-15

    The aim of our proposed system is to confirm the feasibility of extraction of two types of images from one positron emission tomography (PET) module with an insertable collimator for brain tumor treatment during the boron neutron capture therapy (BNCT). The BNCT theory and conceptual diagram of our proposed system are shown fig.1. Data from the PET module, neutron source, and collimator was entered in the Monte Carlon-particle extende source code. We attempted to acquire the PET and SPECT images simultaneously using only PET without an additional isotope. Single photon images were acquired using an insertable collimator on a PET detector.

  20. Potential of boron neutron capture therapy (BNCT) for malignant peripheral nerve sheath tumors (MPNST).

    Science.gov (United States)

    Fujimoto, Takuya; Andoh, Tooru; Sudo, Tamotsu; Fujita, Ikuo; Fukase, Naomasa; Takeuchi, Tamotsu; Sonobe, Hiroshi; Inoue, Masayoshi; Hirose, Tkanori; Sakuma, Toshiko; Moritake, Hiroshi; Sugimoto, Tohru; Kawamoto, Teruya; Fukumori, Yoshinobu; Yamamoto, Satomi; Atagi, Shinji; Sakurai, Yoshinori; Kurosaka, Masahiro; Ono, Koji; Ichikawa, Hideki; Suzuki, Minoru

    2015-12-01

    Malignant peripheral nerve sheath tumors (MPNST) are relatively rare neoplasms with poor prognosis. At present there is no effective treatment for MPNST other than surgical resection. Nonetheless, the anti-tumor effect of boron neutron capture therapy (BNCT) was recently demonstrated in two patients with MPNST. Subsequently, tumor-bearing nude mice subcutaneously transplanted with a human MPNST cell line were injected with p-borono-L-phenylalanine (L-BPA) and subjected to BNCT. Pathological studies then revealed that the MPNST cells were selectively destroyed by BNCT.

  1. Toward a final design for the Birmingham boron neutron capture therapy neutron beam.

    Science.gov (United States)

    Allen, D A; Beynon, T D; Green, S; James, N D

    1999-01-01

    This paper is concerned with the proposed Birmingham accelerator-based epithermal neutron beam for boron neutron capture therapy (BNCT). Details of the final moderator design, such as beam delimiter, shield, and beam exit surface shape are considered. Monte Carlo radiation transport simulations with a head and body phantom have shown that a simple flat moderator beam exit surface is preferable to the previously envisioned spherical design. Dose rates to individual body organs during treatment have been calculated using a standard MIRD phantom. We have shown that a simple polyethylene shield, doped with natural lithium, is sufficient to provide adequate protection to the rest of the body during head irradiations. The effect upon the head phantom dose distributions of the use of such a shield to delimit the therapy beam has been evaluated.

  2. Boron neutron capture therapy for malignant melanoma: first clinical case report in China

    Science.gov (United States)

    Yong, Zhong; Song, Zewen; Zhou, Yongmao; Liu, Tong; Zhang, Zizhu; Zhao, Yanzhong; Chen, Yang; Jin, Congjun; Chen, Xiang; Lu, Jianyun; Han, Rui; Li, Pengzhou; Sun, Xulong; Wang, Guohui; Shi, Guangqing; Zhu, Shaihong

    2016-01-01

    A phase I/II clinical trial for treating malignant melanoma by boron neutron capture therapy (BNCT) was designed to evaluate whether the world’s first in-hospital neutron irradiator (IHNI) was qualified for BNCT. In this clinical trial planning to enroll 30 patients, the first case was treated on August 19, 2014. We present the protocol of this clinical trial, the treating procedure, and the clinical outcome of this first case. Only grade 2 acute radiation injury was observed during the first four weeks after BNCT and the injury healed after treatment. No late radiation injury was found during the 24-month follow-up. Based on positron emission tomography-computed tomography (PET/CT) scan, pathological analysis and gross examination, the patient showed a complete response to BNCT, indicating that BNCT is a potent therapy against malignant melanoma and IHNI has the potential to enable the delivery of BNCT in hospitals. PMID:28174492

  3. Synthesis and evaluation of boron compounds for neutron capture therapy of malignant brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Soloway, A.H.; Barth, R.F.

    1990-01-01

    Boron neutron capture therapy offers the potentiality for treating brain tumors currently resistant to treatment. The success of this form of therapy is directly dependent upon the delivery of sufficient numbers of thermal-neutrons to tumor cells which possess high concentrations of B-10. The objective of this project is to develop chemical methodology to synthesize boron-containing compounds with the potential for becoming incorporated into rapidly-dividing malignant brain tumor cells and excluded from normal components of the brain and surrounding tissues, to develope biological methods for assessing the potential of the compound by use of cell culture or intratumoral injection, to develop analytical methodology for measuring boron in cells and tissue using direct current plasma atomic emission spectroscopy (DCP-AES) and alpha track autoradiography, to develop biochemical and HPLC procedures for evaluating compound uptake and tissue half-life, and to develop procedures required to assess both in vitro and vivo efficacy of BNCT with selected compounds.

  4. Study of characteristics for heavy water photoneutron source in boron neutron capture therapy

    CERN Document Server

    Salehi, Danial; Sardari, Dariush

    2013-01-01

    Bremsstrahlung photon beams produced by medical linear accelerators are currently the most commonly used method of radiation therapy for cancerous tumors. Photons with energies greater than 8-10 MeV potentially generate neutrons through photonuclear interactions in the accelerator's treatment head, patient's body, and treatment room ambient. Electrons impinging on a heavy target generate a cascade shower of bremsstrahlung photons, the energy spectrum of which shows an end point equal to the electron beam energy. By varying the target thickness, an optimum thickness exists for which, at the given electron energy, maximum photon flux is achievable. If a source of high-energy photons i.e. bremsstrahlung, is conveniently directed to a suitable D2O target, a novel approach for production of an acceptable flux of filterable photoneturons for boron neutron capture therapy (BNCT) application is possible. This study consists of two parts. 1. Comparison and assessment of deuterium photonuclear cross section data. 2. Ev...

  5. The dependency of compound biological effectiveness factors on the type and the concentration of administered neutron capture agents in boron neutron capture therapy

    OpenAIRE

    Masunaga, Shin-Ichiro; Sakurai, Yoshinori; Tanaka, Hiroki; Tano, Keizo; Suzuki, Minoru; Kondo, Natsuko; Narabayashi, Masaru; Nakagawa, Yosuke; Watanabe, Tsubasa; Maruhashi, Akira; ONO, KOJI

    2014-01-01

    Purpose To examine the effect of the type and the concentration of neutron capture agents on the values of compound biological effectiveness (CBE) in boron neutron capture therapy. Methods and materials After the subcutaneous administration of a 10 B-carrier, boronophenylalanine- 10 B (BPA) or sodium mercaptododecaborate- 10 B (BSH), at 3 separate concentrations, the 10 B concentrations in tumors were measured by γ-ray spectrometry. SCC VII tumor-bearing C3H/He mice received 5-bromo-2′-deoxyu...

  6. Development of JCDS, a computational dosimetry system at JAEA for boron neutron capture therapy

    Science.gov (United States)

    Kumada, H.; Yamamoto, K.; Matsumura, A.; Yamamoto, T.; Nakagawa, Y.

    2007-06-01

    Clinical trials of boron neutron capture therapy (BNCT) are being carried out using several research reactors throughout the world. In Japan, many medical groups perform clinical trials of BNCT using Japan Research Reactor No.4 (JRR-4) in Japan Atomic Energy Agency (JAEA). JAEA has developed a treatment planning system, JCDS, in order to evaluate radiation dose given to a patient in the BNCT. JCDS employs a voxel calculation method to compute the radiation dose given to a patient. An initial version of JCDS created a voxel model, dividing a space into 1 × 1 × 1 cm3voxel cells. JCDS was improved to create a detailed voxel model consisting of minute voxel cells such as 2 × 2 × 2 mm3voxel cells. Verification of accuracy of calculations with the detailed voxel mode demonstrated that the detailed voxel model enables JCDS to evaluate more accurately the radiation doses to a patient undergoing BNCT. Furthermore, the calculation code of JCDS is being incorporated into the PHITS system as a Monte-Carlo transport code. By employing the PHITS system in the dose evaluation, total doses given to a patient by combined modality therapy such as BNCT and X-ray therapy can be estimated accurately. Here, an outline and the performances of the latest version of JCDS are presented, and a future system integrated with JCDS is introduced.

  7. Spectromicroscopy of boron for the optimization of boron neutron capture therapy (BNCT) for cancer

    Science.gov (United States)

    Gilbert, B.; Redondo, J.; Baudat, P.-A.; Lorusso, G. F.; Andres, R.; Van Meir, E. G.; Brunet, J.-F.; Hamou, M.-F.; Suda, T.; Mercanti, Delio; Ciotti, M. Teresa; Droubay, T. C.; Tonner, B. P.; Perfetti, P.; Margaritondo, M.; DeStasio, Gelsomina

    1998-10-01

    We used synchrotron spectromicroscopy to study the microscopic distribution of boron in rat brain tumour and healthy tissue in the field of boron neutron capture therapy (BNCT). The success of this experimental cancer therapy depends on the preferential uptake of ? in tumour cells after injection of a boron compound (in our case ?, or BSH). With the Mephisto (microscope à emission de photoélectrons par illumination synchrotronique de type onduleur) spectromicroscope, high-magnification imaging and chemical analysis was performed on brain tissue sections from a rat carrying an implanted brain tumour and the results were compared with inductively coupled plasma-atomic emission spectroscopy (ICP-AES) detection of boron in bulk tissue. Boron was found to have been taken up more favourably by regions of tumour rather than healthy tissue, but the resulting boron distribution in the tumour was inhomogeneous. The results demonstrate that Mephisto can perform microchemical analysis of tissue sections, detect and localize the presence of boron with submicron spatial resolution. The application of this technique to boron in brain tissue can therefore be used to evaluate the current efforts to optimize BNC therapy.

  8. Spectromicroscopy of boron for the optimization of boron neutron capture therapy (BNCT) for cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gilbert, B.; Redondo, J.; Baudat, P-A. [Institut de Physique Appliquee, Ecole Polytechnique Federale, Lausanne (Switzerland)] [and others

    1998-10-07

    We used synchrotron spectromicroscopy to study the microscopic distribution of boron in rat brain tumour and healthy tissue in the field of boron neutron capture therapy (BNCT). The success of this experimental cancer therapy depends on the preferential uptake of {sup 10}B in tumour cells after injection of a boron compound (in our case B{sub 12}H{sub 11}SH, or BSH). With the Mephisto (microscope a emission de photoelectrons par illumination synchrotronique de type onduleur) spectromicroscope, high-magnification imaging and chemical analysis was performed on brain tissue sections from a rat carrying an implanted brain tumour and the results were compared with inductively coupled plasma-atomic emission spectroscopy (ICP-AES) detection of boron in bulk tissue. Boron was found to have been taken up more favourably by regions of tumour rather than healthy tissue, but the resulting boron distribution in the tumour was inhomogeneous. The results demonstrate that Mephisto can perform microchemical analysis of tissue sections, detect and localize the presence of boron with submicron spatial resolution. The application of this technique to boron in brain tissue can therefore be used to evaluate the current efforts to optimize BNC therapy. (author)

  9. U.S. Spacesuit Knowledge Capture Accomplishments in Fiscal Year 2015

    Science.gov (United States)

    Chullen, Cinda; Oliva, Vladenka R.

    2016-01-01

    The NASA U.S. Spacesuit Knowledge Capture (SKC) Program continues to capture, share, and archive significant spacesuit-related knowledge with engineers and other technical staff and invested entities. Since its 2007 inception, the SKC Program has hosted and recorded more than 75 events. By the end of Fiscal Year (FY) 2015, 40 of these were processed and uploaded to a publically accessible NASA Web site where viewers can expand their knowledge about the spacesuit's evolution, known capabilities and limitations, and lessons learned. Sharing this knowledge with entities beyond NASA can increase not only more people's understanding of the technical effort and importance involved in designing a spacesuit, it can also expand the interest and support in this valuable program that ensures significant knowledge is retained and accessible. This paper discusses the FY 2015 SKC events, the release and accessibility of the approved events, and the program's future plans.

  10. Boron analysis for neutron capture therapy using particle-induced gamma-ray emission.

    Science.gov (United States)

    Nakai, Kei; Yamamoto, Yohei; Okamoto, Emiko; Yamamoto, Tetsuya; Yoshida, Fumiyo; Matsumura, Akira; Yamada, Naoto; Kitamura, Akane; Koka, Masashi; Satoh, Takahiro

    2015-12-01

    The neutron source of BNCT is currently changing from reactor to accelerator, but peripheral facilities such as a dose-planning system and blood boron analysis have still not been established. To evaluate the potential application of particle-induced gamma-ray emission (PIGE) for boron measurement in clinical boron neutron capture therapy, boronophenylalanine dissolved within a cell culture medium was measured using PIGE. PIGE detected 18 μgB/mL f-BPA in the culture medium, and all measurements of any given sample were taken within 20 min. Two hours of f-BPA exposure was required to create a boron distribution image. However, even though boron remained in the cells, the boron on the cell membrane could not be distinguished from the boron in the cytoplasm.

  11. The filter/moderator arrangement-optimisation for the boron-neutron capture therapy (BNCT).

    Science.gov (United States)

    Tracz, G; Dabkowski, L; Dworak, D; Pytel, K; Woźnicka, U

    2004-01-01

    The paper presents results of the numerical modelling of the fission-converter-based epithermal neutron source designed for the boron neutron capture therapy (BNCT) facility to be located at the Polish research nuclear reactor MARIA at Swierk. The unique design of the fission converter has been proposed due to a specific geometrical surrounding of the reactor. The filter/moderator arrangement has been optimised to moderate fission neutrons to epithermal energies and to remove both fast neutrons and photons from the therapeutic beam. The selected filter/moderator set-up ensures both high epithermal neutron flux and suitably low level of beam contamination. Photons originating from the reactor core are almost eliminated what is the exceptional advantage of the proposed design. It yields one order of magnitude lower gamma radiation dose than the maximum allowed dose in such a type of therapeutic facility. The MCNP code has been used for the computations.

  12. Optimal Neutron Source and Beam Shaping Assembly for Boron Neutron Capture Therapy

    CERN Document Server

    Vujic, J L; Greenspan, E; Guess, S; Karni, Y; Kastenber, W E; Kim, L; Leung, K N; Regev, D; Verbeke, J M; Waldron, W L; Zhu, Y

    2003-01-01

    There were three objectives to this project: (1) The development of the 2-D Swan code for the optimization of the nuclear design of facilities for medical applications of radiation, radiation shields, blankets of accelerator-driven systems, fusion facilities, etc. (2) Identification of the maximum beam quality that can be obtained for Boron Neutron Capture Therapy (BNCT) from different reactor-, and accelerator-based neutron sources. The optimal beam-shaping assembly (BSA) design for each neutron source was also to e obtained. (3) Feasibility assessment of a new neutron source for NCT and other medical and industrial applications. This source consists of a state-of-the-art proton or deuteron accelerator driving and inherently safe, proliferation resistant, small subcritical fission assembly.

  13. Optimal Neutron Source & Beam Shaping Assembly for Boron Neutron Capture Therapy

    Energy Technology Data Exchange (ETDEWEB)

    J. Vujic; E. Greenspan; W.E. Kastenber; Y. Karni; D. Regev; J.M. Verbeke, K.N. Leung; D. Chivers; S. Guess; L. Kim; W. Waldron; Y. Zhu

    2003-04-30

    There were three objectives to this project: (1) The development of the 2-D Swan code for the optimization of the nuclear design of facilities for medical applications of radiation, radiation shields, blankets of accelerator-driven systems, fusion facilities, etc. (2) Identification of the maximum beam quality that can be obtained for Boron Neutron Capture Therapy (BNCT) from different reactor-, and accelerator-based neutron sources. The optimal beam-shaping assembly (BSA) design for each neutron source was also to e obtained. (3) Feasibility assessment of a new neutron source for NCT and other medical and industrial applications. This source consists of a state-of-the-art proton or deuteron accelerator driving and inherently safe, proliferation resistant, small subcritical fission assembly.

  14. Rational design of gold nanoparticles functionalized with carboranes for application in Boron Neutron Capture Therapy.

    Science.gov (United States)

    Ciani, Laura; Bortolussi, Silva; Postuma, Ian; Cansolino, Laura; Ferrari, Cinzia; Panza, Luigi; Altieri, Saverio; Ristori, Sandra

    2013-12-31

    In this paper we propose a bottom-up approach to obtain new boron carriers built with ortho-carborane functionalized gold nanoparticles (GNPs) for applications in Boron Neutron Capture Therapy. The interaction between carboranes and the gold surface was assured by one or two SH-groups directly linked to the boron atoms of the B10C2 cage. This allowed obtaining stable, nontoxic systems, though optimal biological performance was hampered by low solubility in aqueous media. To improve cell uptake, the hydrophilic character of carborane functionalized GNPs was enhanced by further coverage with an appropriately tailored diblock copolymer (PEO-b-PCL). This polymer also contained pendant carboranes to provide anchoring to the pre-functionalized GNPs. In vitro tests, carried out on osteosarcoma cells, showed that the final vectors possessed excellent biocompatibility joint to the capacity of concentrating boron atoms in the target, which is encouraging evidenced to pursue applications in vivo.

  15. Gel dosimeters as useful dose and thermal-fluence detectors in Boron Neutron Capture Therapy (BNCT)

    Energy Technology Data Exchange (ETDEWEB)

    Gambarini, G.; Valente, M. [Department of Physics of the University and INFN, Via Celoria 16, I-20133 Milan (Italy); Moss, R.L.; Daquino, G.G.; Nievaart, V.A. [Joint Research Centre, Institute for Energy, P.O. Box 2, NL-1755ZG Petten, The Netherlands (Netherlands); Mariani, M.; Vanossi, E. [Department of Nuclear Engineering of Polytechnic, CESNEF, Via Ponzio, 34/3 - I-20133 Milan (Italy); Carrara, M. [Medical Physics Department, National Cancer Institute, Via Venezian 1, I-20131, Milan (Italy)

    2006-07-01

    The dosimetry method based on Fricke-Xylenol-Orange-infused gels in form of layers has shown noticeable potentiality for in-phantom or in-free-beam dose and thermal flux profiling and imaging in the high fluxes of thermal or epithermal neutrons utilised for boron neutron capture therapy (BNCT). Gel-dosimeters in form of layers give the possibility not only of obtaining spatial dose distributions but also of achieving measurements of each dose contribution in neutron fields. The discrimination of the various dose components is achieved by means of pixel-to-pixel manipulations of pairs of images obtained with gel-dosimeters having different isotopic composition. It is possible to place large dosimeters, detecting in such a way large dose images, because the layer geometry of dosimeters avoids sensitive variation of neutron transport due to the gel isotopic composition. Some results obtained after the last improvements of the method are reported. (Author)

  16. Characterization of neutron beams for boron neutron capture therapy: in-air radiobiological dosimetry.

    Science.gov (United States)

    Yamamoto, Tetsuya; Matsumura, Akira; Yamamoto, Kazuyoshi; Kumada, Hiroaki; Hori, Naohiko; Torii, Yoshiya; Shibata, Yasushi; Nose, Tadao

    2003-07-01

    The survival curves and the RBE for the dose components generated in boron neutron capture therapy (BNCT) were determined separately in neutron beams at Japan Research Reactor No. 4. The surviving fractions of V79 Chinese hamster cells with or without 10B were obtained using an epithermal neutron beam (ENB), a mixed thermal-epithermal neutron beam (TNB-1), and a thermal (TNB-2) neutron beam; these beams were used or are planned for use in BNCT clinical trials. The cell killing effect of the neutron beam in the presence or absence of 10B was highly dependent on the neutron beam used and depended on the epithermal and fast-neutron content of the beam. The RBEs of the boron capture reaction for ENB, TNB-1 and TNB-2 were 4.07 +/- 0.22, 2.98 +/- 0.16 and 1.42 +/- 0.07, respectively. The RBEs of the high-LET dose components based on the hydrogen recoils and the nitrogen capture reaction were 2.50 +/- 0.32, 2.34 +/- 0.30 and 2.17 +/- 0.28 for ENB, TNB-1 and TNB-2, respectively. The RBEs of the neutron and photon components were 1.22 +/- 0.16, 1.23 +/- 0.16, and 1.21 +/- 0.16 for ENB, TNB-1 and TNB-2, respectively. The approach to the experimental determination of RBEs outlined in this paper allows the RBE-weighted dose calculation for each dose component of the neutron beams and contributes to an accurate inter-beam comparison of the neutron beams at the different facilities employed in ongoing and planned BNCT clinical trials.

  17. The design, construction and performance of a variable collimator for epithermal neutron capture therapy beams

    Science.gov (United States)

    Riley, K. J.; Binns, P. J.; Ali, S. J.; Harling, O. K.

    2004-05-01

    A patient collimator for the fission converter based epithermal neutron beam (FCB) at the Massachusetts Institute of Technology Research Reactor (MITR-II) was built for clinical trials of boron neutron capture therapy (BNCT). A design was optimized by Monte Carlo simulations of the entire beam line and incorporates a modular construction for easy modifications in the future. The device was formed in-house by casting a mixture of lead spheres (7.6 mm diameter) in epoxy resin loaded with either 140 mg cm-3 of boron carbide or 210 mg cm-3 of lithium fluoride (95% enriched in 6Li). The cone shaped collimator allows easy field placement anywhere on the patient and is equipped with a laser indicator of central axis, beam's eye view optics and circular apertures of 80, 100, 120 and 160 mm diameter. Beam profiles and the collateral dose in a half-body phantom were measured for the 160 mm field using fission counters, activation foils as well as tissue equivalent (A-150) and graphite walled ionization chambers. Leakage radiation through the collimator contributes less than 10% to the total collateral dose up to 0.15 m beyond the edge of the aperture and becomes relatively more prominent with lateral displacement. The measured whole body dose equivalent of 24 ± 2 mSv per Gy of therapeutic dose is comparable to doses received during conventional therapy and is due principally (60-80%) to thermal neutron capture reactions with boron. These findings, together with the dose distributions for the primary beam, demonstrate the suitability of this patient collimator for BNCT.

  18. The design, construction and performance of a variable collimator for epithermal neutron capture therapy beams.

    Science.gov (United States)

    Riley, K J; Binns, P J; Ali, S J; Harling, O K

    2004-05-21

    A patient collimator for the fission converter based epithermal neutron beam (FCB) at the Massachusetts Institute of Technology Research Reactor (MITR-II) was built for clinical trials of boron neutron capture therapy (BNCT). A design was optimized by Monte Carlo simulations of the entire beam line and incorporates a modular construction for easy modifications in the future. The device was formed in-house by casting a mixture of lead spheres (7.6 mm diameter) in epoxy resin loaded with either 140 mg cm(-3) of boron carbide or 210 mg cm(-3) of lithium fluoride (95% enriched in 6Li). The cone shaped collimator allows easy field placement anywhere on the patient and is equipped with a laser indicator of central axis, beam's eye view optics and circular apertures of 80, 100, 120 and 160 mm diameter. Beam profiles and the collateral dose in a half-body phantom were measured for the 160 mm field using fission counters, activation foils as well as tissue equivalent (A-150) and graphite walled ionization chambers. Leakage radiation through the collimator contributes less than 10% to the total collateral dose up to 0.15 m beyond the edge of the aperture and becomes relatively more prominent with lateral displacement. The measured whole body dose equivalent of 24 +/- 2 mSv per Gy of therapeutic dose is comparable to doses received during conventional therapy and is due principally (60-80%) to thermal neutron capture reactions with boron. These findings, together with the dose distributions for the primary beam, demonstrate the suitability of this patient collimator for BNCT.

  19. DNA damage induced by boron neutron capture therapy is partially repaired by DNA ligase IV.

    Science.gov (United States)

    Kondo, Natsuko; Sakurai, Yoshinori; Hirota, Yuki; Tanaka, Hiroki; Watanabe, Tsubasa; Nakagawa, Yosuke; Narabayashi, Masaru; Kinashi, Yuko; Miyatake, Shin-ichi; Hasegawa, Masatoshi; Suzuki, Minoru; Masunaga, Shin-ichiro; Ohnishi, Takeo; Ono, Koji

    2016-03-01

    Boron neutron capture therapy (BNCT) is a particle radiation therapy that involves the use of a thermal or epithermal neutron beam in combination with a boron ((10)B)-containing compound that specifically accumulates in tumor. (10)B captures neutrons and the resultant fission reaction produces an alpha ((4)He) particle and a recoiled lithium nucleus ((7)Li). These particles have the characteristics of high linear energy transfer (LET) radiation and therefore have marked biological effects. High-LET radiation is a potent inducer of DNA damage, specifically of DNA double-strand breaks (DSBs). The aim of the present study was to clarify the role of DNA ligase IV, a key player in the non-homologous end-joining repair pathway, in the repair of BNCT-induced DSBs. We analyzed the cellular sensitivity of the mouse embryonic fibroblast cell lines Lig4-/- p53-/- and Lig4+/+ p53-/- to irradiation using a thermal neutron beam in the presence or absence of (10)B-para-boronophenylalanine (BPA). The Lig4-/- p53-/- cell line had a higher sensitivity than the Lig4+/+ p53-/-cell line to irradiation with the beam alone or the beam in combination with BPA. In BNCT (with BPA), both cell lines exhibited a reduction of the 50 % survival dose (D 50) by a factor of 1.4 compared with gamma-ray and neutron mixed beam (without BPA). Although it was found that (10)B uptake was higher in the Lig4+/+ p53-/- than in the Lig4-/- p53-/- cell line, the latter showed higher sensitivity than the former, even when compared at an equivalent (10)B concentration. These results indicate that BNCT-induced DNA damage is partially repaired using DNA ligase IV.

  20. Optimization of the geometry and composition of a neutron system for treatment by Boron Neutron Capture Therapy

    OpenAIRE

    2015-01-01

    Background: In the field of the treatment by Boron Neutron Capture Therapy (BNCT), an optimized neutron system was proposed. This study (simulation) was conducted to optimize the geometry and composition of neutron system and increase the epithermal neutron flux for the treatment of deep tumors is performed. Materials and Methods: A neutron system for BNCT was proposed. The system included 252Cf neutron source, neutron moderator/reflector arrangement, filter and concrete. To capture fast ...

  1. A Project of Boron Neutron Capture Therapy System based on a Proton Linac Neutron Source

    Science.gov (United States)

    Kiyanagi, Yoshikai; Asano, Kenji; Arakawa, Akihiro; Fukuchi, Shin; Hiraga, Fujio; Kimura, Kenju; Kobayashi, Hitoshi; Kubota, Michio; Kumada, Hiroaki; Matsumoto, Hiroshi; Matsumoto, Akira; Sakae, Takeji; Saitoh, Kimiaki; Shibata, Tokushi; Yoshioka, Masakazu

    At present, the clinical trials of Boron Neutron Capture Therapy (BNCT) are being performed at research reactor facilities. However, an accelerator based BNCT has a merit that it can be built in a hospital. So, we just launched a development project for the BNCT based on an accelerator in order to establish and to spread the BNCT as an effective therapy in the near future. In the project, a compact proton linac installed in a hospital will be applied as a neutron source, and energy of the proton beam is planned to be less than about 10 MeV to reduce the radioactivity. The BNCT requires epithermal neutron beam with an intensity of around 1x109 (n/cm2/sec) to deliver the therapeutic dose to a deeper region in a body and to complete the irradiation within an hour. From this condition, the current of the proton beam required is estimated to be a few mA on average. Enormous heat deposition in the target is a big issue. We are aiming at total optimization of the accelerator based BNCT from the linac to the irradiation position. Here, the outline of the project is introduced and the moderator design is presented.

  2. Design of a californium-based epithermal neutron beam for neutron capture therapy.

    Science.gov (United States)

    Yanch, J C; Kim, J K; Wilson, M J

    1993-08-01

    The potential of the spontaneously fissioning isotope, 252Cf, to provide epithermal neutrons for use in boron neutron capture therapy (BNCT) has been investigated using Monte Carlo simulation. The Monte Carlo code MCNP was used to design an assembly composed of a 26 cm long, 11 cm radius cylindrical D2O moderator followed by a 64 cm long Al filter. Lithium filters are placed between the moderator and the filter and between the Al and the patient. A reflector surrounding the moderator/filter assembly is required in order to maintain adequate therapy flux at the patient position. An ellipsoidal phantom composed of skull- and brain-equivalent material was used to determine the dosimetric effect of this beam. It was found that both advantage depths and advantage ratios compare very favourably with reactor and accelerator epithermal neutron sources. The dose rate obtainable, on the other hand, is 4.1 RBE cGy min-1, based on a very large (1.0 g) source of 252Cf. This dose rate is two to five times lower than those provided by existing reactor beams and can be viewed as a drawback of using 252Cf as a neutron source. Radioisotope sources, however, do offer the advantage of in-hospital installation.

  3. Potential of using boric acid as a boron drug for boron neutron capture therapy for osteosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, C.F.; Lin, S.Y. [Institute of Nuclear Engineering and Science, National Tsing Hua University, Taiwan (China); Peir, J.J. [Nuclear Science and Technology Development Center, National Tsing Hua University, Taiwan (China); Liao, J.W. [Graduate Institute of Veterinary Pathobiology, National Chung Hsing University, Taiwan (China); Lin, Y.C. [Department of Veterinary Medicine, National Chung Hsing University, Taiwan (China); Chou, F.I., E-mail: fichou@mx.nthu.edu.tw [Institute of Nuclear Engineering and Science, National Tsing Hua University, Taiwan (China)] [Nuclear Science and Technology Development Center, National Tsing Hua University, Taiwan (China)

    2011-12-15

    Osteosarcoma is a malignant tumor commonly found in human and animals. The ability of boric acid (BA) to accumulate in osteosarcoma due to the mechanism of the bone formation of cancer cells would make boron neutron capture therapy (BNCT) an alternative therapy for osteosarcoma. This study evaluated the feasibility of using BA as the boron drug for BNCT of bone cancer. The cytotoxicity of BA to L929 cells exceeded that of UMR-106 cells. With 25 {mu}g {sup 10}B/mL medium of BA treatment, the boron concentration in UMR-106 cells was higher than that in L929 cells. The biodistribution and pharmacokinetics of BA in Sprague-Dawley (SD) rats were studied by administrating 25 mg {sup 10}B/kg body weight to SD rats. Blood boron level decreased rapidly within one hour after BA injection. Boron concentration in the long bone was 4-6 time higher than that of blood. Results of this study suggest that BA may be a potential drug for BNCT for osteosarcoma.

  4. Synthesis and evaluation of boron folates for Boron-Neutron-Capture-Therapy (BNCT)

    Energy Technology Data Exchange (ETDEWEB)

    Kettenbach, Kathrin; Schieferstein, Hanno; Grunewald, Catrin; Hampel, Gabriele; Schuetz, Christian L. [Mainz Univ. (Germany). Inst. of Nuclear Chemistry; Iffland, Dorothee; Bings, Nicolas H. [Mainz Univ. (Germany). Inst. of Inorganic Chemistry and Analytical Chemistry; Reffert, Laura M. [Hannover Medical School (Germany). Radiopharmaceutical Chemistry; Ross, Tobias L. [Mainz Univ. (Germany). Inst. of Nuclear Chemistry; Hannover Medical School (Germany). Radiopharmaceutical Chemistry

    2015-07-01

    Boron neutron capture therapy (BNCT) employs {sup 10}B-pharmaceuticals administered for the treatment of malignancies, and subsequently irradiated with thermal neutrons. So far, clinical established pharmaceuticals like boron phenylalanine (BPA) or sodium boron mercaptate (BSH) use imperfect (BPA) or passive (BSH) targeting for accumulation at target sites. Due to the need of a selective transportation of boron drugs into cancer cells and sparing healthy tissues, we combined the BNCT approach with the specific and effective folate receptor (FR) targeting concept. The FR is overexpressed on many human carcinomas and provides a selective and specific target for molecular imaging as well as for tumor therapy. We synthesized and characterized a carborane-folate as well as a BSH-folate to study their in vitro characteristics and their potential as new boron-carriers for BNCT. Uptake studies were carried out using human KB cells showing a significant increase of the boron content in cells and demonstrating the successful combination of active FR-targeting and BNCT.

  5. Characteristics of a heavy water photoneutron source in boron neutron capture therapy

    Institute of Scientific and Technical Information of China (English)

    Danial Salehi; Dariush Sardari; M.Salehi Jozani

    2013-01-01

    Bremsstrahlung photon beams produced by medical linear accelerators are currently the most commonly used method of radiation therapy for cancerous tumors.Photons with energies greater than 8-10 MeV potentially generate neutrons through photonuclear interactions in the accelerator's treatment head,patient's body,and treatment room ambient.Electrons impinging on a heavy target generate a cascade shower of bremsstrahlung photons,the energy spectrum of which shows an end point equal to the electron beam energy.By varying the target thickness,an optimum thickness exists for which,at the given electron energy,maximum photon flux is achievable.If a source of high-energy photons i.e.bremsstrahlung,is conveniently directed to a suitable D2O target,a novel approach for production of an acceptable flux of filterable photoneturons for boron neutron capture therapy (BNCT) application is possible.This study consists of two parts.1.Comparison and assessment of deuterium photonuclear cross section data.2.Evaluation of the heavy water photonuclear source.

  6. Application of generalized perturbation theory to sensitivity analysis in boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, Vanessa S. [Universidade Federal Fluminense (EEIMVR/UFF-RJ), Volta Redonda, RJ (Brazil). Escola de Engenharia Industrial e Metalurgica. Programa de Pos-Graduacao em Modelagem Computacional em Ciencia e Tecnologia; Silva, Fernando C.; Silva, Ademir X., E-mail: fernando@con.ufrj.b, E-mail: ademir@con.ufrj.b [Coordenacao dos Programas de Pos-Graduacao de Engenharia (PEN/COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear; Alvarez, Gustavo B. [Universidade Federal Fluminense (EEIMVR/UFF-RJ), Volta Redonda, RJ (Brazil). Escola de Engenharia Industrial e Metalurgica. Dept. de Ciencias Exatas

    2011-07-01

    Boron neutron capture therapy - BNCT - is a binary cancer treatment used in brain tumors. The tumor is loaded with a boron compound and subsequently irradiated by thermal neutrons. The therapy is based on the {sup 10}B (n, {alpha}) {sup 7}Li nuclear reaction, which emits two types of high-energy particles, {alpha} particle and the {sup 7}Li nuclei. The total kinetic energy released in this nuclear reaction, when deposited in the tumor region, destroys the cancer cells. Since the success of the BNCT is linked to the different selectivity between the tumor and healthy tissue, it is necessary to carry out a sensitivity analysis to determinate the boron concentration. Computational simulations are very important in this context because they help in the treatment planning by calculating the lowest effective absorbed dose rate to reduce the damage to healthy tissue. The objective of this paper is to present a deterministic method based on generalized perturbation theory (GPT) to perform sensitivity analysis with respect to the {sup 10}B concentration and to estimate the absorbed dose rate by patients undergoing this therapy. The advantage of the method is a significant reduction in computational time required to perform these calculations. To simulate the neutron flux in all brain regions, the method relies on a two-dimensional neutron transport equation whose spatial, angular and energy variables are discretized by the diamond difference method, the discrete ordinate method and multigroup formulation, respectively. The results obtained through GPT are consistent with those obtained using other methods, demonstrating the efficacy of the proposed method. (author)

  7. Selective uptake of p-boronophenylalanine by osteosarcoma cells for boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ferrari, C. [Department of Surgery, Experimental Surgery Laboratory, University of Pavia, Piazza Botta, Pavia (Italy)], E-mail: ferraric@unipv.it; Zonta, C.; Cansolino, L.; Clerici, A.M.; Gaspari, A. [Department of Surgery, Experimental Surgery Laboratory, University of Pavia, Piazza Botta, Pavia (Italy); Altieri, S.; Bortolussi, S.; Stella, S. [Department of Nuclear and Theoretical Physics of University, Via Bassi, 6, Pavia (Italy); National Institute of Nuclear Physics (INFN) Section of Pavia, Via Bassi, 6, Pavia (Italy); Bruschi, P. [Department of Nuclear and Theoretical Physics of University, Via Bassi, 6, Pavia (Italy); Dionigi, P.; Zonta, A. [Department of Surgery, Experimental Surgery Laboratory, University of Pavia, Piazza Botta, Pavia (Italy)

    2009-07-15

    Osteosarcoma is the most common non-hematologic primary cancer type that develops in bone. Current osteosarcoma treatments combine multiagent chemotherapy with extensive surgical resection, which in some cases makes necessary the amputation of the entire limb. Nevertheless its infiltrative growth leads to a high incidence of local and distant recurrences that reduce the percentage of cured patients to less than 60%. These poor data required to set up a new therapeutic approach aimed to restrict the surgical removal meanwhile performing a radical treatment. Boron neutron capture therapy (BNCT), a particular radiotherapy based on the nuclear capture and fission reactions by atoms of {sup 10}B, when irradiated with thermal neutrons, could be a valid alternative or integrative option in case of osteosarcoma management, thanks to its peculiarity in selectively destroying neoplastic cells without damaging normal tissues. Aim of the present work is to investigate the feasibility of employing BNCT to treat the limb osteosarcoma. Boronophenylalanine (BPA) is used to carry {sup 10}B inside the neoplastic cells. As a first step the endocellular BPA uptake is tested in vitro on the UMR-106 osteosarcoma cell line. The results show an adequate accumulation capability. For the in vivo experiments, an animal tumor model is developed in Sprague-Dawley rats by means of an intrafemoral injection of UMR-106 cells at the condyle site. The absolute amounts of boron loading and the tumor to normal tissue {sup 10}B ratio are evaluated 2 h after the i.v. administration of BPA. The boron uptake by the neoplastic tissue is almost twice the normal one. However, higher values of boron concentration in tumor are requested before upholding BNCT as a valid therapeutic option in the treatment of osteosarcoma.

  8. Boron nanoparticles inhibit turnour growth by boron neutron capture therapy in the murine B16-OVA model

    DEFF Research Database (Denmark)

    Petersen, Mikkel Steen; Petersen, Charlotte Christie; Agger, Ralf;

    2008-01-01

    Background: Boron neutron capture therapy usually relies on soluble, rather than particulate, boron compounds. This study evaluated the use of a novel boron nanoparticle for boron neutron capture therapy. Materials and Methods: Two hundred and fifty thousand B16-OVA tumour cells, pre......-incubated with boron nanoparticles for 12 hours, were injected subcutaneously into C57BL16J mice. The tumour sites were exposed to different doses of neutron radiation one, four, or eight days after tumour cell inoculation. Results: When the tumour site was irradiated with thermal neutrons one day after injection......, tumour growth was delayed and the treated mice survived longer than untreated controls (median survival time 20 days (N=8) compared with 10 days (N=7) for untreated mice). Conclusion: Boron nanoparticles significantly delay the growth of an aggressive B16-OVA tumour in vivo by boron neutron capture...

  9. Convection enhanced delivery of carboranylporphyrins for neutron capture therapy of brain tumors.

    Science.gov (United States)

    Kawabata, Shinji; Yang, Weilian; Barth, Rolf F; Wu, Gong; Huo, Tianyao; Binns, Peter J; Riley, Kent J; Ongayi, Owendi; Gottumukkala, Vijay; Vicente, M Graça H

    2011-06-01

    Boron neutron capture therapy (BNCT) is based on the nuclear capture and fission reactions that occur when non-radioactive 10B is irradiated with low energy thermal neutrons to produce α-particles (10B[n,α] Li). Carboranylporphyrins are a class of substituted porphyrins containing multiple carborane clusters. Three of these compounds, designated H2TBP, H2TCP, and H2DCP, have been evaluated in the present study. The goals were two-fold. First, to determine their biodistribution following intracerebral (i.c.) administration by short term (30 min) convection enhanced delivery (CED) or sustained delivery over 24 h by Alzet™ osmotic pumps to F98 glioma bearing rats. Second, to determine the efficacy of H2TCP and H2TBP as boron delivery agents for BNCT in F98 glioma bearing rats. Tumor boron concentrations immediately after i.c. pump delivery were high and they remained so at 24 h. The corresponding normal brain concentrations were low and the blood and liver concentrations were undetectable. Based on these data, therapy studies were initiated at the Massachusetts Institute of Technology (MIT) Research Reactor (MITR) with H2TCP and H2TBP 24 h after CED or pump delivery. Mean survival times (MST) ± standard deviations of animals that had received H2TCP or H2TBP, followed by BNCT, were of 35 ± 4 and 44 ± 10 days, compared to 23 ± 3 and 27 ± 3 days, respectively, for untreated and irradiated controls. However, since the tumor boron concentrations of the carboranylporphyrins were 3-5× higher than intravenous (i.v.) boronophenylalanine (BPA), we had expected that the MSTs would have been greater. Histopathologic examination of brains of BNCT treated rats revealed that there were large numbers of porphyrin-laden macrophages, as well as extracellular accumulations of porphyrins, indicating that the seemingly high tumor boron concentrations did not represent the true tumor cellular uptake. Nevertheless, our data are the first to show that carboranyl porphyrins can be

  10. Hemorrhage in mouse tumors induced by dodecaborate cluster lipids intended for boron neutron capture therapy

    Directory of Open Access Journals (Sweden)

    Schaffran T

    2014-07-01

    Full Text Available Tanja Schaffran,1 Nan Jiang,1 Markus Bergmann,2,3 Ekkehard Küstermann,4 Regine Süss,5 Rolf Schubert,5 Franz M Wagner,6 Doaa Awad,7 Detlef Gabel1,2,8 1Department of Chemistry, University of Bremen, 2Institute of Neuropathology, Klinikum Bremen-Mitte; 3Cooperative Center Medicine, University of Bremen, 4“In-vivo-MR” AG, FB2, University of Bremen, Bremen, 5Pharmaceutical Technology, University of Freiburg, Freiburg im Breisgau, 6Forschungsneutronenquelle Heinz Maier-Leibnitz (FRM II, Technische Unversitaet Muenchen, Garching, Germany; 7Department of Biochemistry, Alexandria University, Alexandria, Egypt; 8School of Engineering and Science, Jacobs University Bremen, Bremen, Germany Abstract: The potential of boron-containing lipids with three different structures, which were intended for use in boron neutron capture therapy, was investigated. All three types of boron lipids contained the anionic dodecaborate cluster as the headgroup. Their effects on two different tumor models in mice following intravenous injection were tested; for this, liposomes with boron lipid, distearoyl phosphatidylcholine, and cholesterol as helper lipids, and containing a polyethylene glycol lipid for steric protection, were administered intravenously into tumor-bearing mice (C3H mice for SCCVII squamous cell carcinoma and BALB/c mice for CT26/WT colon carcinoma. With the exception of one lipid (B-THF-14, the lipids were well tolerated, and no other animal was lost due to systemic toxicity. The lipid which led to death was not found to be much more toxic in cell culture than the other boron lipids. All of the lipids that were well tolerated showed hemorrhage in both tumor models within a few hours after administration. The hemorrhage could be seen by in vivo magnetic resonance and histology, and was found to occur within a few hours. The degree of hemorrhage depended on the amount of boron administered and on the tumor model. The observed unwanted effect of the lipids

  11. The Anti-Proliferative Effect of Boron Neutron Capture Therapy in a Prostate Cancer Xenograft Model.

    Directory of Open Access Journals (Sweden)

    Kiyoshi Takahara

    Full Text Available Boron neutron capture therapy (BNCT is a selective radiation treatment for tumors that preferentially accumulate drugs carrying the stable boron isotope, 10B. BNCT has been evaluated clinically as an alternative to conventional radiation therapy for the treatment of brain tumors, and more recently, recurrent advanced head and neck cancer. Here we investigated the effect of BNCT on prostate cancer (PCa using an in vivo mouse xenograft model that we have developed.Mice bearing the xenotransplanted androgen-independent human PCa cell line, PC3, were divided into four groups: Group 1: untreated controls; Group 2: Boronophenylalanine (BPA; Group 3: neutron; Group 4: BPA-mediated BNCT. We compared xenograft growth among these groups, and the body weight and any motility disturbance were recorded. Immunohistochemical (IHC studies of the proliferation marker, Ki-67, and TUNEL staining were performed 9 weeks after treatment.The in vivo studies demonstrated that BPA-mediated BNCT significantly delayed tumor growth in comparison with the other groups, without any severe adverse events. There was a significant difference in the rate of freedom from gait abnormalities between the BPA-mediated BNCT group and the other groups. The IHC studies revealed that BNCT treatment significantly reduced the number of Ki-67-positive cells in comparison with the controls (mean ± SD 6.9 ± 1.5 vs 12.7 ± 4.0, p<0.05, while there was no difference in the number of apoptotic cells, suggesting that BPA-mediated BNCT reduced PCa progression without affecting apoptosis at 9 weeks post-treatment.This study has provided the first preclinical proof-of-principle data to indicate that BPA-mediated BNCT reduces the in vivo growth of PCa. Although further studies will be necessary, BNCT might be a novel potential treatment for PCa.

  12. Can epithermal boron neutron capture therapy treat primary and metastatic liver cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Wallace, S.A. [Austin Repatriation Medical Centre, Heidelberg (Australia); Carolan, M.C. [Illawarra Cancer Care Centre, Wollongong (Australia); Allen, B.J. [St George Cancer Care Centre, Kogarah (Australia)

    1996-12-31

    Full text: The poor prognosis of metastatic cancer to the liver calls for the investigation of alternative treatment modalities. This paper analyses the possible use of epithermal boron neutron capture therapy for the palliative treatment of these cancers. We examine possible treatment planning scenarios for selected tumour to liver boron ratios, and specifically for the epithermal beam at the HFR, Petten. It is required that a therapeutic ratio> 1 be achieved over the entire organ. Monte Carlo calculations were performed using the radiation transport code MCNP. The geometrical model used a `variable voxel` technique to reconstruct an anthropomorphic phantom from CT scans. Regions of interest such as the liver were modelled to a resolution of a few millimetres, whereas surrounding regions were modelled with lesser detail thereby facilitating faster computation time. Three dimensional dose distributions were calculated for a frontal beam directed at the liver, and found to be in satisfactory agreement with measurements using bare and cadmium covered gold foils, PIN and MOSFET dosimeters for fast neutron and gamma measurements respectively. Dose distributions were calculated for orthogonal epithermal neutron beams to the front and side, using the parameters of the epithermal beam at Petten, and assumed tumour and normal tissue boron-10 concentrations of 30 ppm and 7.5 ppm boron-10 respectively. The therapeutic ratio (i e the dose to the tumour relative to the maximum dose to normal tissue) was found to be about 1.8, reducing to unity for the limiting condition of a tumour in the posterior liver. This result opens up the possibility of palliative therapy for the management of primary and metastatic liver cancer.

  13. Dosimetric evaluation of neutron capture therapy for local advanced breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yanagie, H. [Department of Nuclear Engineering and Management, Graduate School of Engineering, University of Tokyo, Tokyo (Japan); Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan)], E-mail: yanagie@n.t.u-tokyo.ac.jp; Kumada, H. [Japan Atomic Research Institute, Ibaraki (Japan); Sakurai, Y. [Research Reactor Institute, Kyoto University, Osaka (Japan); Nakamura, T. [Japan Atomic Research Institute, Ibaraki (Japan); Department of Nuclear Physics, Ibaraki University, Ibaraki (Japan); Furuya, Y. [Department of Surgery, Satukidai Hospital, Chiba (Japan); Sugiyama, H. [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Ono, K. [Research Reactor Institute, Kyoto University, Osaka (Japan); Takamoto, S. [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Department of Cardiac Surgery, University of Tokyo Hospital, Tokyo (Japan); Eriguchi, M. [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Department of Microbiology, Syowa University School of Pharmaceutical Sciences, Tokyo (Japan); Takahashi, H. [Department of Nuclear Engineering and Management, Graduate School of Engineering, University of Tokyo, Tokyo (Japan); Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan)

    2009-07-15

    Local recurrence breast cancer is one of the most difficult conditions to cure and there is a need for new therapy. If sufficient boron compound can be targeted to the tumor, boron neutron capture therapy (BNCT) can be applied to local recurrent breast cancer. In this study, we performed a preliminary dosimetry with a phantom model of the mammary gland at Kyoto University Research Reactor (KUR), and a feasibility dosimetry with JAERI Computational Dosimetry System (JCDS) at JRR4 reactor of Japan Atomic Research Institute. We performed preliminary dosimetry of a phantom model of the mammary gland with thermal neutron irradiation (OO-0011 mode) on LiF collimation at KUR. The thermal neutron flux was 5.16 E+08 cm{sup -2} s{sup -1} at the surface of phantom. The blood boron concentration is estimated to be 30 ppm; tumor boron concentration is also estimated to be 90 ppm according to tumor/blood ratio 3 and skin/blood ratio 1.2. Tumor RBE dose is estimated to be 47 Gy/h, and skin RBE dose is 12.4 Gy/h. In case of advanced breast cancer, we performed the feasibility estimation of 3D construction of tumor according to the MRI imaging of a patient with epithermal neutron mode at JRR4. The blood boron concentration (ppm) and tumor/normal tissue ratio are estimated to be 24 and 3.5, respectively. Skin RBE dose is restricted to 10 Gy/h, the maximum tumor RBE dose, minimum tumor RBE dose, and mean tumor RBE dose are 42.2, 11.3, and 28.9 Gy-Eq, respectively, in half hour irradiation. In this study, we showed the possibility to apply BNCT to local recurrent breast cancer. We can irradiate tumors selectively and as safely as possible, reducing the effects on neighboring healthy tissues.

  14. Lithium Nitride Synthesized by in situ Lithium Deposition and Ion Implantation for Boron Neutron Capture Therapy

    Science.gov (United States)

    Ishitama, Shintaro; Baba, Yuji; Fujii, Ryo; Nakamura, Masaru; Imahori, Yoshio

    Li3N synthesis on Li deposition layer was conducted without H2O and O2 by in situ lithium deposition in high vacuum chamber of 10-6 Pa and ion implantation techniques and the thermo-chemical stability of the Li3N/Li/Cu tri-layered target for Boron Neutron Capture Therapy (BNCT) under laser heating and air exposure was characterized by X-ray photoelectron spectroscopy (XPS). Following conclusions were derived; (1) Li3N/Li/Cu tri-layered target with very low oxide and carbon contamination was synthesized by in situ lithium vacuum deposition and N2+ ion implantation without H2O and O2 additions, (2) The starting temperature of evaporation of Li3N/Li/Cu tri-layered target increased by 120K compared to that of the Li/Cu target and (3) Remarkable oxidation and carbon contamination were observed on the surface of Li3N/Li/Cu after air exposure and these contaminated compositions was not removed by Ar+ heavy sputtering.

  15. High-power liquid-lithium target prototype for accelerator-based boron neutron capture therapy.

    Science.gov (United States)

    Halfon, S; Paul, M; Arenshtam, A; Berkovits, D; Bisyakoev, M; Eliyahu, I; Feinberg, G; Hazenshprung, N; Kijel, D; Nagler, A; Silverman, I

    2011-12-01

    A prototype of a compact Liquid-Lithium Target (LiLiT), which will possibly constitute an accelerator-based intense neutron source for Boron Neutron Capture Therapy (BNCT) in hospitals, was built. The LiLiT setup is presently being commissioned at Soreq Nuclear Research Center (SNRC). The liquid-lithium target will produce neutrons through the (7)Li(p,n)(7)Be reaction and it will overcome the major problem of removing the thermal power generated using a high-intensity proton beam (>10 kW), necessary for sufficient neutron flux. In off-line circulation tests, the liquid-lithium loop generated a stable lithium jet at high velocity, on a concave supporting wall; the concept will first be tested using a high-power electron beam impinging on the lithium jet. High intensity proton beam irradiation (1.91-2.5 MeV, 2-4 mA) will take place at Soreq Applied Research Accelerator Facility (SARAF) superconducting linear accelerator currently in construction at SNRC. Radiological risks due to the (7)Be produced in the reaction were studied and will be handled through a proper design, including a cold trap and appropriate shielding. A moderator/reflector assembly is planned according to a Monte Carlo simulation, to create a neutron spectrum and intensity maximally effective to the treatment and to reduce prompt gamma radiation dose risks.

  16. Boronated monoclonal antibody 225. 28S for potential use in neutron capture therapy of malignant melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Tamat, S.R.; Moore, D.E.; Patwardhan, A.; Hersey, P. (Univ. of Sydney (Australia))

    1989-07-01

    The concept of conjugating boron cluster compounds to monoclonal antibodies has been examined by several groups of research workers in boron neutron capture therapy (BNCT). The procedures reported to date for boronation of monoclonal antibodies resulted in either an inadequate level of boron incorporation, the precipitation of the conjugates, or a loss of immunological activity. The present report describes the conjugation of dicesium-mercapto-undecahydrododecaborate (Cs2B12H11SH) to 225.28S monoclonal antibody directed against high molecular weight melanoma-associated antigens (HMW-MAA), using poly-L-ornithine as a bridge to increase the carrying capacity of the antibody and to minimize change in the conformational structure of antibody. The method produces a boron content of 1,300 to 1,700 B atoms per molecule 225.28S while retaining the immunoreactivity. Characterization in terms of the homogeneity of the conjugation of the boron-monoclonal antibody conjugates has been studied by gel electrophoresis and ion-exchange HPLC.

  17. Boron microquantification in oral mucosa and skin following administration of a neutron capture therapy agent

    Energy Technology Data Exchange (ETDEWEB)

    Kiger, S.W. III; Micca, P.L.; Morris, G.M.; Coderre, J.A

    2002-07-01

    Clinical trials of boron neutron capture therapy (BNCT) for intracranial tumours using boronphenylalanine-fructose undertaken at Harvard-MIT and Brookhaven National Laboratory have observed acute normal tissue reactions in the skin and oral mucosa. Because the range of the {sup 10}B(n,a){sup 7}Li reaction products is very short, 10-14 {mu}m combined, knowledge of the 10B microdistribution in tissue is critical for understanding the microdosimetry and radiobiology of BNCT. This paper reports measurements of the microdistribution of {sup 10}B in an animal model, rat skin and tongue, using high resolution quantitative autoradiography (HRQAR), a neutron-induced track etch autoradiographic technique. The steep spatial gradient and high absolute value relative to blood of the {sup 10}B concentration observed in some strata of the rat tongue epithelium and skin are important for properly evaluating the radiobiology and the biological effectiveness factors for normal tissue reactions such as oral mucositis, which are generally assessed using the blood boron concentration rather than the tissue boron concentration. (author)

  18. Monte Carlo simulation of depth dose distribution in several organic models for boron neutron capture therapy

    Science.gov (United States)

    Matsumoto, T.

    2007-09-01

    Monte Carlo simulations are performed to evaluate depth-dose distributions for possible treatment of cancers by boron neutron capture therapy (BNCT). The ICRU computational model of ADAM & EVA was used as a phantom to simulate tumors at a depth of 5 cm in central regions of the lungs, liver and pancreas. Tumors of the prostate and osteosarcoma were also centered at the depth of 4.5 and 2.5 cm in the phantom models. The epithermal neutron beam from a research reactor was the primary neutron source for the MCNP calculation of the depth-dose distributions in those cancer models. For brain tumor irradiations, the whole-body dose was also evaluated. The MCNP simulations suggested that a lethal dose of 50 Gy to the tumors can be achieved without reaching the tolerance dose of 25 Gy to normal tissue. The whole-body phantom calculations also showed that the BNCT could be applied for brain tumors without significant damage to whole-body organs.

  19. Verification of the computational dosimetry system in JAERI (JCDS) for boron neutron capture therapy

    Science.gov (United States)

    Kumada, H.; Yamamoto, K.; Matsumura, A.; Yamamoto, T.; Nakagawa, Y.; Nakai, K.; Kageji, T.

    2004-08-01

    Clinical trials for boron neutron capture therapy (BNCT) by using the medical irradiation facility installed in Japan Research Reactor No. 4 (JRR-4) at Japan Atomic Energy Research Institute (JAERI) have been performed since 1999. To carry out the BNCT procedure based on proper treatment planning and its precise implementation, the JAERI computational dosimetry system (JCDS) which is applicable to dose planning has been developed in JAERI. The aim of this study was to verify the performance of JCDS. The experimental data with a cylindrical water phantom were compared with the calculation results using JCDS. Data of measurements obtained from IOBNCT cases at JRR-4 were also compared with retrospective evaluation data with JCDS. In comparison with phantom experiments, the calculations and the measurements for thermal neutron flux and gamma-ray dose were in a good agreement, except at the surface of the phantom. Against the measurements of clinical cases, the discrepancy of JCDS's calculations was approximately 10%. These basic and clinical verifications demonstrated that JCDS has enough performance for the BNCT dosimetry. Further investigations are recommended for precise dose distribution and faster calculation environment.

  20. Thermal neutron irradiation field design for boron neutron capture therapy of human explanted liver.

    Science.gov (United States)

    Bortolussi, S; Altieri, S

    2007-12-01

    The selective uptake of boron by tumors compared to that by healthy tissue makes boron neutron capture therapy (BNCT) an extremely advantageous technique for the treatment of tumors that affect a whole vital organ. An example is represented by colon adenocarcinoma metastases invading the liver, often resulting in a fatal outcome, even if surgical resection of the primary tumor is successful. BNCT can be performed by irradiating the explanted organ in a suitable neutron field. In the thermal column of the Triga Mark II reactor at Pavia University, a facility was created for this purpose and used for the irradiation of explanted human livers. The neutron field distribution inside the organ was studied both experimentally and by means of the Monte Carlo N-particle transport code (MCNP). The liver was modeled as a spherical segment in MCNP and a hepatic-equivalent solution was used as an experimental phantom. In the as-built facility, the ratio between maximum and minimum flux values inside the phantom ((phi(max)/phi(min)) was 3.8; this value can be lowered to 2.3 by rotating the liver during the irradiation. In this study, the authors proposed a new facility configuration to achieve a uniform thermal neutron flux distribution in the liver. They showed that a phi(max)/phi(min) ratio of 1.4 could be obtained without the need for organ rotation. Flux distributions and dose volume histograms were reported for different graphite configurations.

  1. Induced radioactivity in the blood of cancer patients following Boron Neutron Capture Therapy.

    Science.gov (United States)

    Fujiwara, Keiko; Kinashi, Yuko; Takahashi, Tomoyuki; Yashima, Hiroshi; Kurihara, Kouta; Sakurai, Yoshinori; Tanaka, Hiroki; Ono, Koji; Takahashi, Sentaro

    2013-07-01

    Since 1990, Boron Neutron Capture Therapy (BNCT) has been used for over 400 cancer patients at the Kyoto University Research Reactor Institute (KURRI). After BNCT, the patients are radioactive and their (24)Na and (38)Cl levels can be detected via a Na-I scintillation counter. This activity is predominantly due to (24)Na, which has a half-life of 14.96 h and thus remains in the body for extended time periods. Radioactive (24)Na is mainly generated from (23)Na in the target tissue that is exposed to the neutron beam in BNCT. The purpose of this study is to evaluate the relationship between the radioactivity of blood (24)Na following BNCT and the absorbed gamma ray dose in the irradiated field. To assess blood (24)Na, 1 ml of peripheral blood was collected from 30 patients immediately after the exposure, and the radioactivity of blood (24)Na was determined using a germanium counter. The activity of (24)Na in the blood correlated with the absorbed gamma ray doses in the irradiated field. For the same absorbed gamma ray dose in the irradiated field, the activity of blood (24)Na was higher in patients with neck or lung tumors than in patients with brain or skin tumors. The reasons for these findings are not readily apparent, but the difference in the blood volume and the ratio of bone to soft tissue in the irradiated field, as well as the dose that leaked through the clinical collimator, may be responsible.

  2. Improvement of dose distribution by central beam shielding in boron neutron capture therapy

    Science.gov (United States)

    Sakurai, Yoshinori; Ono, Koji

    2007-12-01

    Since boron neutron capture therapy (BNCT) with epithermal neutron beams started at the Kyoto University Reactor (KUR) in June 2002, nearly 200 BNCT treatments have been carried out. The epithermal neutron irradiation significantly improves the dose distribution, compared with the previous irradiation mainly using thermal neutrons. However, the treatable depth limit still remains. One effective technique to improve the limit is the central shield method. Simulations were performed for the incident neutron energies and the annular components of the neutron source. It was clear that thermal neutron flux distribution could be improved by decreasing the lower energy neutron component and the inner annular component of the incident beam. It was found that a central shield of 4-6 cm diameter and 10 mm thickness is effective for the 12 cm diameter irradiation field. In BNCT at KUR, the depth dose distribution can be much improved by the central shield method, resulting in a relative increase of the dose at 8 cm depth by about 30%. In addition to the depth dose distribution, the depth dose profile is also improved. As the dose rate in the central area is reduced by the additional shielding, the necessary irradiation time, however, increases by about 30% compared to normal treatment.

  3. Alanine and TLD coupled detectors for fast neutron dose measurements in neutron capture therapy (NCT).

    Science.gov (United States)

    Cecilia, A; Baccaro, S; Cemmi, A; Colli, V; Gambarini, G; Rosi, G; Scolari, L

    2004-01-01

    A method was investigated to measure gamma and fast neutron doses in phantoms exposed to an epithermal neutron beam designed for neutron capture therapy (NCT). The gamma dose component was measured by TLD-300 [CaF2:Tm] and the fast neutron dose, mainly due to elastic scattering with hydrogen nuclei, was measured by alanine dosemeters [CH3CH(NH2)COOH]. The gamma and fast neutron doses deposited in alanine dosemeters are very near to those released in tissue, because of the alanine tissue equivalence. Couples of TLD-300 and alanine dosemeters were irradiated in phantoms positioned in the epithermal column of the Tapiro reactor (ENEA-Casaccia RC). The dosemeter response depends on the linear energy transfer (LET) of radiation, hence the precision and reliability of the fast neutron dose values obtained with the proposed method have been investigated. Results showed that the combination of alanine and TLD detectors is a promising method to separate gamma dose and fast neutron dose in NCT.

  4. Gyrotron-driven high current ECR ion source for boron-neutron capture therapy neutron generator

    Science.gov (United States)

    Skalyga, V.; Izotov, I.; Golubev, S.; Razin, S.; Sidorov, A.; Maslennikova, A.; Volovecky, A.; Kalvas, T.; Koivisto, H.; Tarvainen, O.

    2014-12-01

    Boron-neutron capture therapy (BNCT) is a perspective treatment method for radiation resistant tumors. Unfortunately its development is strongly held back by a several physical and medical problems. Neutron sources for BNCT currently are limited to nuclear reactors and accelerators. For wide spread of BNCT investigations more compact and cheap neutron source would be much more preferable. In present paper an approach for compact D-D neutron generator creation based on a high current ECR ion source is suggested. Results on dense proton beams production are presented. A possibility of ion beams formation with current density up to 600 mA/cm2 is demonstrated. Estimations based on obtained experimental results show that neutron target bombarded by such deuteron beams would theoretically yield a neutron flux density up to 6·1010 cm-2/s. Thus, neutron generator based on a high-current deuteron ECR source with a powerful plasma heating by gyrotron radiation could fulfill the BNCT requirements significantly lower price, smaller size and ease of operation in comparison with existing reactors and accelerators.

  5. Dosimetric effects of beam size and collimation of epithermal neutrons for boron neutron capture therapy.

    Science.gov (United States)

    Yanch, J C; Harling, O K

    1993-08-01

    A series of studies of "ideal" beams has been carried out using Monte Carlo simulation with the goal of providing guidance for the design of epithermal beams for boron neutron capture therapy (BNCT). An "ideal" beam is defined as a monoenergetic, photon-free source of neutrons with user-specified size, shape and angular dependence of neutron current. The dosimetric behavior of monoenergetic neutron beams in an elliptical phantom composed of brain-equivalent material has been assessed as a function of beam diameter and neutron emission angle (beam angle), and the results are reported here. The simulation study indicates that substantial differences exist in the dosimetric behavior of small and large neutron beams (with respect to the phantom) as a function of the extent of beam collimation. With a small beam, dose uniformity increases as the beam becomes more isotropic (less collimated); the opposite is seen with large beams. The penetration of thermal neutrons is enhanced as the neutron emission angle is increased with a small beam; again the opposite trend is seen with large beams. When beam size is small, the dose delivered per neutron is very dependent on the extent of beam collimation; this does not appear to be the case with a larger beam. These trends in dose behavior are presented graphically and discussed in terms of their effect on several figures of merit, the advantage depth, the advantage ratio, and the advantage depth-dose rate. Tables giving quick summaries of these results are provided.

  6. Progress towards boron neutron capture therapy at the High Flux Reactor Petten.

    Science.gov (United States)

    Moss, R L

    1990-01-01

    During 1988 the first positive steps were taken to proceed with the design and construction of a neutron capture therapy facility on the High Flux Reactor (HFR) at Petten. The immediate aim is to realise within a short time (summer 1989), an epithermal neutron beam for radiobiological and filter optimisation studies on one of the 10 small aperture horizontal beam tubes. The following summer, a much larger neutron beam, i.e., in cross section and neutron fluence rate, will be constructed on one of the two large beam tubes that replaced the old thermal column in 1984. This latter beam tube faces one whole side of the reactor vessel, extending from a 50 x 40 cm input aperture to a 35 x 35 cm exit hole. The radiotherapeutic facility will be housed here, with the intention to start clinical trials at the beginning of 1991. This paper describes the present status of the project and includes: a general description of the pertinent characteristics with respect to NCT of the HFR; results of the recently completed preliminary neutron metrology and computer modeling at the input end of the candidate beam tube; the structure and planning of the proposed Work Programme; and the respective direct and indirect participation and collaboration with the Netherlands Cancer Institute and the European Collaboration Group on BNCT.

  7. Designing accelerator-based epithermal neutron beams for boron neutron capture therapy.

    Science.gov (United States)

    Bleuel, D L; Donahue, R J; Ludewigt, B A; Vujic, J

    1998-09-01

    The 7Li(p,n)7Be reaction has been investigated as an accelerator-driven neutron source for proton energies between 2.1 and 2.6 MeV. Epithermal neutron beams shaped by three moderator materials, Al/AlF3, 7LiF, and D2O, have been analyzed and their usefulness for boron neutron capture therapy (BNCT) treatments evaluated. Radiation transport through the moderator assembly has been simulated with the Monte Carlo N-particle code (MCNP). Fluence and dose distributions in a head phantom were calculated using BNCT treatment planning software. Depth-dose distributions and treatment times were studied as a function of proton beam energy and moderator thickness. It was found that an accelerator-based neutron source with Al/AlF3 or 7LiF as moderator material can produce depth-dose distributions superior to those calculated for a previously published neutron beam design for the Brookhaven Medical Research Reactor, achieving up to approximately 50% higher doses near the midline of the brain. For a single beam treatment, a proton beam current of 20 mA, and a 7LiF moderator, the treatment time was estimated to be about 40 min. The tumor dose deposited at a depth of 8 cm was calculated to be about 21 Gy-Eq.

  8. Gyrotron-driven high current ECR ion source for boron-neutron capture therapy neutron generator

    Energy Technology Data Exchange (ETDEWEB)

    Skalyga, V., E-mail: skalyga.vadim@gmail.com [Institute of Applied Physics, RAS, 46 Ul’yanova st., 603950 Nizhny Novgorod (Russian Federation); Lobachevsky State University of Nizhny Novgorod (UNN), 23 Gagarina st., 603950 Nizhny Novgorod (Russian Federation); Izotov, I.; Golubev, S.; Razin, S. [Institute of Applied Physics, RAS, 46 Ul’yanova st., 603950 Nizhny Novgorod (Russian Federation); Sidorov, A. [Institute of Applied Physics, RAS, 46 Ul’yanova st., 603950 Nizhny Novgorod (Russian Federation); Lobachevsky State University of Nizhny Novgorod (UNN), 23 Gagarina st., 603950 Nizhny Novgorod (Russian Federation); Maslennikova, A. [Lobachevsky State University of Nizhny Novgorod (UNN), 23 Gagarina st., 603950 Nizhny Novgorod (Russian Federation); Nizhny Novgorod State Medical Academy, 10/1 Minina Sq., 603005 Nizhny Novgorod (Russian Federation); Volovecky, A. [Lobachevsky State University of Nizhny Novgorod (UNN), 23 Gagarina st., 603950 Nizhny Novgorod (Russian Federation); Kalvas, T.; Koivisto, H.; Tarvainen, O. [University of Jyvaskyla, Department of Physics, PO Box 35 (YFL), 40500 Jyväskylä (Finland)

    2014-12-21

    Boron-neutron capture therapy (BNCT) is a perspective treatment method for radiation resistant tumors. Unfortunately its development is strongly held back by a several physical and medical problems. Neutron sources for BNCT currently are limited to nuclear reactors and accelerators. For wide spread of BNCT investigations more compact and cheap neutron source would be much more preferable. In present paper an approach for compact D–D neutron generator creation based on a high current ECR ion source is suggested. Results on dense proton beams production are presented. A possibility of ion beams formation with current density up to 600 mA/cm{sup 2} is demonstrated. Estimations based on obtained experimental results show that neutron target bombarded by such deuteron beams would theoretically yield a neutron flux density up to 6·10{sup 10} cm{sup −2}/s. Thus, neutron generator based on a high-current deuteron ECR source with a powerful plasma heating by gyrotron radiation could fulfill the BNCT requirements significantly lower price, smaller size and ease of operation in comparison with existing reactors and accelerators.

  9. Boron neutron capture therapy (BNCT) for liver metastasis: therapeutic efficacy in an experimental model

    Energy Technology Data Exchange (ETDEWEB)

    David W. Nigg

    2012-08-01

    Boron neutron capture therapy (BNCT) was proposed for untreatable colorectal liver metastases. The present study evaluates tumor control and potential radiotoxicity of BNCT in an experimental model of liver metastasis. BDIX rats were inoculated with syngeneic colon cancer cells DHD/K12/TRb. Tumor-bearing animals were divided into three groups: BPA–BNCT, boronophenylalanine (BPA) ? neutron irradiation; Beam only, neutron irradiation; Sham, matched manipulation. The total absorbed dose administered with BPA–BNCT was 13 ± 3 Gy in tumor and 9 ± 2 Gy in healthy liver. Three weeks posttreatment, the tumor surface area post-treatment/pre-treatment ratio was 0.46 ± 0.20 for BPA–BNCT, 2.7 ± 1.8 for Beam only and 4.5 ± 3.1 for Sham. The pre-treatment tumor nodule mass of 48 ± 19 mgfell significantly to 19 ± 16 mg for BPA–BNCT, but rose significantly to 140 ± 106 mg for Beam only and to 346 ± 302 mg for Sham. For both end points, the differences between the BPA–BNCT group and each of the other groups were statistically significant (ANOVA). No clinical, macroscopic or histological normal liver radiotoxicity was observed. It is concluded that BPA– BNCT induced a significant remission of experimental colorectal tumor nodules in liver with no contributory liver toxicity.

  10. An accelerator-based epithermal photoneutron source for boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, H.E.

    1996-04-01

    Boron neutron capture therapy is an experimental binary cancer radiotherapy modality in which a boronated pharmaceutical that preferentially accumulates in malignant tissue is first administered, followed by exposing the tissue in the treatment volume to a thermal neutron field. Current usable beams are reactor-based but a viable alternative is the production of an epithermal neutron beam from an accelerator. Current literature cites various proposed accelerator-based designs, most of which are based on proton beams with beryllium or lithium targets. This dissertation examines the efficacy of a novel approach to BNCT treatments that incorporates an electron linear accelerator in the production of a photoneutron source. This source may help to resolve some of the present concerns associated with accelerator sources, including that of target cooling. The photoneutron production process is discussed as a possible alternate source of neutrons for eventual BNCT treatments for cancer. A conceptual design to produce epithermal photoneutrons by high photons (due to bremsstrahlung) impinging on deuterium targets is presented along with computational and experimental neutron production data. A clinically acceptable filtered epithermal neutron flux on the order of 10{sup 7} neutrons per second per milliampere of electron current is shown to be obtainable. Additionally, the neutron beam is modified and characterized for BNCT applications by employing two unique moderating materials (an Al/AlF{sub 3} composite and a stacked Al/Teflon design) at various incident electron energies.

  11. Design and Simulation of Photoneutron Source by MCNPX Monte Carlo Code for Boron Neutron Capture Therapy

    Directory of Open Access Journals (Sweden)

    Mona Zolfaghari

    2015-07-01

    Full Text Available Introduction Electron linear accelerator (LINAC can be used for neutron production in Boron Neutron Capture Therapy (BNCT. BNCT is an external radiotherapeutic method for the treatment of some cancers. In this study, Varian 2300 C/D LINAC was simulated as an electron accelerator-based photoneutron source to provide a suitable neutron flux for BNCT. Materials and Methods Photoneutron sources were simulated, using MCNPX Monte Carlo code. In this study, a 20 MeV LINAC was utilized for electron-photon reactions. After the evaluation of cross-sections and threshold energies, lead (Pb, uranium (U and beryllium deuteride (BeD2were selected as photoneutron sources. Results According to the simulation results, optimized photoneutron sources with a compact volume and photoneutron yields of 107, 108 and 109 (n.cm-2.s-1 were obtained for Pb, U and BeD2 composites. Also, photoneutrons increased by using enriched U (10-60% as an electron accelerator-based photoneutron source. Conclusion Optimized photoneutron sources were obtained with compact sizes of 107, 108 and 109 (n.cm-2.s-1, respectively. These fluxs can be applied for BNCT by decelerating fast neutrons and using a suitable beam-shaping assembly, surrounding electron-photon and photoneutron sources.

  12. Investigation of Isfahan miniature neutron source reactor (MNSR for boron neutron capture therapy by MCNP simulation

    Directory of Open Access Journals (Sweden)

    S.Z Kalantari

    2015-01-01

    Full Text Available One of the important neutron sources for Boron Neutron Capture Therapy (BNCT is a nuclear reactor. It needs a high flux of epithermal neutrons. The optimum conditions of the neutron spectra for BNCT are provided by the International Atomic Energy Agency (IAEA. In this paper, Miniature Neutron Source Reactor (MNSR as a neutron source for BNCT was investigated. For this purpose, we designed a Beam Shaping Assembly (BSA for the reactor and the neutron transport from the core of the reactor to the output windows of BSA was simulated by MCNPX code. To optimize the BSA performance, two sets of parameters should be evaluated, in-air and in-phantom parameters. For evaluating in-phantom parameters, a Snyder head phantom was used and biological dose rate and dose-depth curve were calculated in brain normal and tumor tissues. Our calculations showed that the neutron flux of the MNSR reactor can be used for BNCT, and the designed BSA in optimum conditions had a good therapeutic characteristic for BNCT.

  13. Beam neutron energy optimization for boron neutron capture therapy using Monte Carlo method

    Directory of Open Access Journals (Sweden)

    Ali Pazirandeh

    2006-06-01

    Full Text Available  In last two decades the optimal neutron energy for the treatment of deep seated tumors in boron neutron capture therapy in view of neutron physics and chemical compounds of boron carrier has been under thorough study. Although neutron absorption cross section of boron is high (3836b, the treatment of deep seated tumors such as gliobelastoma multiform (GBM requires beam of neutrons of higher energy that can penetrate deeply into the brain and thermalize in the proximity of the tumor. Dosage from recoil proton associated with fast neutrons however poses some constraints on maximum neutron energy that can be used in the treatment. For this reason neutrons in the epithermal energy range of 10eV-10keV are generally to be the most appropriate. The simulation carried out by Monte Carlo methods using MCBNCT and MCNP4C codes along with the cross section library in 290 groups extracted from ENDF/B6 main library. The optimal neutron energy for deep seated tumors depends on the size and depth of tumor. Our estimated optimized energy for the tumor of 5cm wide and 1-2cm thick stands at 5cm depth is in the range of 3-5keV

  14. Inborn errors in metabolism and 4-boronophenylalanine-fructose-based boron neutron capture therapy.

    Science.gov (United States)

    Laakso, Juha; Ruokonen, Inkeri; Lapatto, Risto; Kallio, Merja

    2003-11-01

    Infusions of boronophenylalanine-fructose complex (BPA-F), at doses up to 900 mg/kg of BPA and 860 mg/kg of fructose, have been used to deliver boron to cancer tissue for boron neutron capture therapy (BNCT). In patients with phenylketonuria (PKU), phenylalanine accumulates, which is harmful in the long run. PKU has been an exclusion criterion for BPA-F-mediated BNCT. Fructose is harmful to individuals with hereditary fructose intolerance (HFI) in amounts currently used in BNCT. The harmful effects are mediated through induction of hypoglycemia and acidosis, which may lead to irreversible organ damage or even death. Consequently, HFI should be added as an exclusion criterion for BNCT if fructose-containing solutions are used in boron carriers. Non-HFI subjects may also develop symptoms, such as gastrointestinal pain, if the fructose infusion rate is high. We therefore recommend monitoring of glucose levels and correcting possible hypoglycemia promptly. Except for some populations with extremely low PKU prevalence, HFI and PKU prevalences are similar, approximately 1 or 2 per 20,000.

  15. A fundamental study on hyper-thermal neutrons for neutron capture therapy.

    Science.gov (United States)

    Sakurai, Y; Kobayashi, T; Kanda, K

    1994-12-01

    The utilization of hyper-thermal neutrons, which have an energy spectrum with a Maxwellian distribution at a higher temperature than room temperature (300 K), was studied in order to improve the thermal neutron flux distribution at depth in a living body for neutron capture therapy. Simulation calculations were carried out using a Monte Carlo code 'MCNP-V3' in order to investigate the characteristics of hyper-thermal neutrons, i.e. (i) depth dependence of the neutron energy spectrum, and (ii) depth distribution of the reaction rate in a water phantom for materials with 1/v neutron absorption. It is confirmed that hyper-thermal neutron irradiation can improve the thermal neutron flux distribution in the deeper areas in a living body compared with thermal neutron irradiation. When hyper-thermal neutrons with a 3000 K Maxwellian distribution are incident on a body, the reaction rates of 1/v materials such as 14N, 10B etc are about twice that observed for incident thermal neutrons at 300 K, at a depth of 5 cm. The limit of the treatable depth for tumours having 30 ppm 10B is expected to be about 1.5 cm greater by utilizing hyper-thermal neutrons at 3000 K compared with the incidence of thermal neutrons at 300 K.

  16. Dynamic infrared imaging for biological and medical applications in Boron neutron capture therapy

    Science.gov (United States)

    Santa Cruz, Gustavo A.; González, Sara J.; Dagrosa, Alejandra; Schwint, Amanda E.; Carpano, Marina; Trivillin, Verónica A.; Boggio, Esteban F.; Bertotti, José; Marín, Julio; Monti Hughes, Andrea; Molinari, Ana J.; Albero, Miguel

    2011-05-01

    Boron Neutron Capture Therapy (BNCT) is a treatment modality, currently focused on the treatment of cancer, which involves a tumor selective 10B compound and a specially tuned neutron beam to produce a lethal nuclear reaction. BNCT kills target cells with microscopic selectivity while sparing normal tissues from potentially lethal doses of radiation. In the context of the Argentine clinical and research BNCT projects at the National Atomic Energy Commission and in a strong collaboration with INVAP SE, we successfully implemented Dynamic Infrared Imaging (DIRI) in the clinical setting for the observation of cutaneous melanoma patients and included DIRI as a non invasive methodology in several research protocols involving small animals. We were able to characterize melanoma lesions in terms of temperature and temperature rate-of-recovery after applying a mild cold thermal stress, distinguishing melanoma from other skin pigmented lesions. We observed a spatial and temporal correlation between skin acute reactions after irradiation, the temperature pattern and the dose distribution. We studied temperature distribution as a function of tumor growth in mouse xenografts, observing a significant correlation between tumor temperature and drug uptake; we investigated temperature evolution in the limbs of Wistar rats for a protocol of induced rheumatoid arthritis (RA), DIRI being especially sensitive to RA induction even before the development of clinical signs and studied surface characteristics of tumors, precancerous and normal tissues in a model of oral cancer in the hamster cheek pouch.

  17. Epithermal neutron formation for boron neutron capture therapy by adiabatic resonance crossing concept

    Science.gov (United States)

    Khorshidi, A.; Ghafoori-Fard, H.; Sadeghi, M.

    2014-05-01

    Low-energy protons from the cyclotron in the range of 15-30 MeV and low current have been simulated on beryllium (Be) target with a lead moderator around the target. This research was accomplished to design an epithermal neutron beam for Boron Neutron Capture Therapy (BNCT) using the moderated neutron on the average produced from 9Be target via (p, xn) reaction in Adiabatic Resonance Crossing (ARC) concept. Generation of neutron to proton ratio, energy distribution, flux and dose components in head phantom have been simulated by MCNP5 code. The reflector and collimator were designed in prevention and collimation of derivation neutrons from proton bombarding. The scalp-skull-brain phantom consisting of bone and brain equivalent material has been simulated in order to evaluate the dosimetric effect on the brain. Results of this analysis demonstrated while the proton energy decreased, the dose factor altered according to filters thickness. The maximum epithermal flux revealed using fluental, Fe and bismuth (Bi) filters with thicknesses of 9.4, 3 and 2 cm, respectively and also the epithermal to thermal neutron flux ratio was 103.85. The potential of the ARC method to replace or complement the current reactor-based supply sources of BNCT purposes.

  18. Nanostructured Boron Nitride With High Water Dispersibility For Boron Neutron Capture Therapy

    Science.gov (United States)

    Singh, Bikramjeet; Kaur, Gurpreet; Singh, Paviter; Singh, Kulwinder; Kumar, Baban; Vij, Ankush; Kumar, Manjeet; Bala, Rajni; Meena, Ramovatar; Singh, Ajay; Thakur, Anup; Kumar, Akshay

    2016-10-01

    Highly water dispersible boron based compounds are innovative and advanced materials which can be used in Boron Neutron Capture Therapy for cancer treatment (BNCT). Present study deals with the synthesis of highly water dispersible nanostructured Boron Nitride (BN). Unique and relatively low temperature synthesis route is the soul of present study. The morphological examinations (Scanning/transmission electron microscopy) of synthesized nanostructures showed that they are in transient phase from two dimensional hexagonal sheets to nanotubes. It is also supported by dual energy band gap of these materials calculated from UV- visible spectrum of the material. The theoretically calculated band gap also supports the same (calculated by virtual nano lab Software). X-ray diffraction (XRD) analysis shows that the synthesized material has deformed structure which is further supported by Raman spectroscopy. The structural aspect of high water disperse ability of BN is also studied. The ultra-high disperse ability which is a result of structural deformation make these nanostructures very useful in BNCT. Cytotoxicity studies on various cell lines (Hela(cervical cancer), human embryonic kidney (HEK-293) and human breast adenocarcinoma (MCF-7)) show that the synthesized nanostructures can be used for BNCT.

  19. GPU-based prompt gamma ray imaging from boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Do-Kun; Jung, Joo-Young; Suk Suh, Tae, E-mail: suhsanta@catholic.ac.kr [Department of Biomedical Engineering and Research Institute of Biomedical Engineering, College of Medicine, Catholic University of Korea, Seoul 505 137-701 (Korea, Republic of); Jo Hong, Key [Molecular Imaging Program at Stanford (MIPS), Department of Radiology, Stanford University, 300 Pasteur Drive, Stanford, California 94305 (United States); Sil Lee, Keum [Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, California 94305-5847 (United States)

    2015-01-15

    Purpose: The purpose of this research is to perform the fast reconstruction of a prompt gamma ray image using a graphics processing unit (GPU) computation from boron neutron capture therapy (BNCT) simulations. Methods: To evaluate the accuracy of the reconstructed image, a phantom including four boron uptake regions (BURs) was used in the simulation. After the Monte Carlo simulation of the BNCT, the modified ordered subset expectation maximization reconstruction algorithm using the GPU computation was used to reconstruct the images with fewer projections. The computation times for image reconstruction were compared between the GPU and the central processing unit (CPU). Also, the accuracy of the reconstructed image was evaluated by a receiver operating characteristic (ROC) curve analysis. Results: The image reconstruction time using the GPU was 196 times faster than the conventional reconstruction time using the CPU. For the four BURs, the area under curve values from the ROC curve were 0.6726 (A-region), 0.6890 (B-region), 0.7384 (C-region), and 0.8009 (D-region). Conclusions: The tomographic image using the prompt gamma ray event from the BNCT simulation was acquired using the GPU computation in order to perform a fast reconstruction during treatment. The authors verified the feasibility of the prompt gamma ray image reconstruction using the GPU computation for BNCT simulations.

  20. Development of the JAERI computational dosimetry system (JCDS) for boron neutron capture therapy. Cooperative research

    CERN Document Server

    Kumada, H; Matsumura, A; Nakagawa, Y; Nose, T; Torii, Y; Uchiyama, J; Yamamoto, K; Yamamoto, T

    2003-01-01

    The Neutron Beam Facility at JRR-4 enables us to carry out boron neutron capture therapy with epithermal neutron beam. In order to make treatment plans for performing the epithermal neutron beam BNCT, it is necessary to estimate radiation doses in a patient's head in advance. The JAERI Computational Dosimetry System (JCDS), which can estimate distributions of radiation doses in a patient's head by simulating in order to support the treatment planning for epithermal neutron beam BNCT, was developed. JCDS is a software that creates a 3-dimentional head model of a patient by using CT and MRI images, and that generates a input data file automatically for calculation of neutron flux and gamma-ray dose distributions in the brain with the Monte Carlo code MCNP, and that displays these dose distributions on the head model for dosimetry by using the MCNP calculation results. JCDS has any advantages as follows; By using CT data and MRI data which are medical images, a detail three-dimensional model of patient's head is...

  1. An accelerator-based epithermal photoneutron source for boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, Hannah E. [Georgia Inst. of Technology, Atlanta, GA (United States)

    1996-04-01

    Boron neutron capture therapy is an experimental binary cancer radiotherapy modality in which a boronated pharmaceutical that preferentially accumulates in malignant tissue is first administered, followed by exposing the tissue in the treatment volume to a thermal neutron field. Current usable beams are reactor-based but a viable alternative is the production of an epithermal neutron beam from an accelerator. Current literature cites various proposed accelerator-based designs, most of which are based on proton beams with beryllium or lithium targets. This dissertation examines the efficacy of a novel approach to BNCT treatments that incorporates an electron linear accelerator in the production of a photoneutron source. This source may help to resolve some of the present concerns associated with accelerator sources, including that of target cooling. The photoneutron production process is discussed as a possible alternate source of neutrons for eventual BNCT treatments for cancer. A conceptual design to produce epithermal photoneutrons by high photons (due to bremsstrahlung) impinging on deuterium targets is presented along with computational and experimental neutron production data. A clinically acceptable filtered epithermal neutron flux on the order of 107 neutrons per second per milliampere of electron current is shown to be obtainable. Additionally, the neutron beam is modified and characterized for BNCT applications by employing two unique moderating materials (an Al/AlF3 composite and a stacked Al/Teflon design) at various incident electron energies.

  2. Boron neutron capture therapy of brain tumors: an emerging therapeutic modality.

    Science.gov (United States)

    Barth, R F; Soloway, A H; Goodman, J H; Gahbauer, R A; Gupta, N; Blue, T E; Yang, W; Tjarks, W

    1999-03-01

    Boron neutron capture therapy (BNCT) is based on the nuclear reaction that occurs when boron-10, a stable isotope, is irradiated with low-energy thermal neutrons to yield alpha particles and recoiling lithium-7 nuclei. For BNCT to be successful, a large number of 10B atoms must be localized on or preferably within neoplastic cells, and a sufficient number of thermal neutrons must be absorbed by the 10B atoms to sustain a lethal 10B (n, alpha) lithium-7 reaction. There is a growing interest in using BNCT in combination with surgery to treat patients with high-grade gliomas and possibly metastatic brain tumors. The present review covers the biological and radiobiological considerations on which BNCT is based, boron-containing low- and high-molecular weight delivery agents, neutron sources, clinical studies, and future areas of research. Two boron compounds currently are being used clinically, sodium borocaptate and boronophenylalanine, and a number of new delivery agents are under investigation, including boronated porphyrins, nucleosides, amino acids, polyamines, monoclonal and bispecific antibodies, liposomes, and epidermal growth factor. These are discussed, as is optimization of their delivery. Nuclear reactors currently are the only source of neutrons for BNCT, and the fission reaction within the core produces a mixture of lower energy thermal and epithermal neutrons, fast or high-energy neutrons, and gamma-rays. Although thermal neutron beams have been used clinically in Japan to treat patients with brain tumors and cutaneous melanomas, epithermal neutron beams now are being used in the United States and Europe because of their superior tissue-penetrating properties. Currently, there are clinical trials in progress in the United States, Europe, and Japan using a combination of debulking surgery and then BNCT to treat patients with glioblastomas. The American and European studies are Phase I trials using boronophenylalanine and sodium borocaptate, respectively

  3. 22 years of photodynamic therapy in China

    Science.gov (United States)

    Li, Jun-Heng

    2005-07-01

    The development of laser medicine in China is correlated with the development of laser science in China. The first Chinese ruby laser was created in 1961. Chinese pharmacists produced the Chinese HpD in 1981 and the first case of PDT was treated using Chinese HpD and Chinese laser equipment in the same year in Beijing. Its success brought attention establishing a research group supported by the government in 1982. A systemic research on PDT was then carried out and obvious results were achieved. The step taken for PDT also accelerated the researches on other kinds of laser medicine and surgery. Since 1982, thousands of patients of malignant tumors including tumors of the lung, esophagus, cardia, stomach, rectum, bladder, other urinary genital organs, face and mouth, eyes, ENT, head and neck, breast, and skin were treated using PDT in China. HpD fluorescence was examined in some centers. Except the superficial tumor cases, PDT procedures were done through the endoscopes. Since 1990"s, imaging guided percutaneous PDT was adopted in the organs cannot be reached by the endoscopes, such as liver cancer, peripheral lung cancer and others. PDT can be used for non-malignant cases such as occlusion of blood vessels, for example, we invented the treatment of port wine stains by PDT. Regular surgical operation combined with PDT for cerebral glioma showed to be a very good combination. HpD has been approved by the Chinese Government as a photosensitizer, so it is legal to be used in PDT. There are some second generation photosensitizers under studying in China, such as Hematoporphyrin monomethyl ether (HMME) etc. Lasers used for PDT now are mostly the diode laser of 630nm for the cancers. Research studies for PDT in China may be focalized on the aspects as new photosensitizers; the dosimetry in laser irradiation; atoptosis induced by PDT; preclinical and clinical studies for PDT new indications and new technologies.

  4. Biodistribution of sodium borocaptate (BSH) for boron neutron capture therapy (BNCT) in an oral cancer model.

    Science.gov (United States)

    Garabalino, Marcela A; Heber, Elisa M; Monti Hughes, Andrea; González, Sara J; Molinari, Ana J; Pozzi, Emiliano C C; Nievas, Susana; Itoiz, Maria E; Aromando, Romina F; Nigg, David W; Bauer, William; Trivillin, Verónica A; Schwint, Amanda E

    2013-08-01

    Boron neutron capture therapy (BNCT) is based on selective accumulation of ¹⁰B carriers in tumor followed by neutron irradiation. We previously proved the therapeutic success of BNCT mediated by the boron compounds boronophenylalanine and sodium decahydrodecaborate (GB-10) in the hamster cheek pouch oral cancer model. Based on the clinical relevance of the boron carrier sodium borocaptate (BSH) and the knowledge that the most effective way to optimize BNCT is to improve tumor boron targeting, the specific aim of this study was to perform biodistribution studies of BSH in the hamster cheek pouch oral cancer model and evaluate the feasibility of BNCT mediated by BSH at nuclear reactor RA-3. The general aim of these studies is to contribute to the knowledge of BNCT radiobiology and optimize BNCT for head and neck cancer. Sodium borocaptate (50 mg ¹⁰B/kg) was administered to tumor-bearing hamsters. Groups of 3-5 animals were killed humanely at nine time-points, 3-12 h post-administration. Samples of blood, tumor, precancerous pouch tissue, normal pouch tissue and other clinically relevant normal tissues were processed for boron measurement by optic emission spectroscopy. Tumor boron concentration peaked to therapeutically useful boron concentration values of 24-35 ppm. The boron concentration ratio tumor/normal pouch tissue ranged from 1.1 to 1.8. Pharmacokinetic curves showed that the optimum interval between BSH administration and neutron irradiation was 7-11 h. It is concluded that BNCT mediated by BSH at nuclear reactor RA-3 would be feasible.

  5. Feasibility study on epithermal neutron field for cyclotron-based boron neutron capture therapy.

    Science.gov (United States)

    Yonai, Shunsuke; Aoki, Takao; Nakamura, Takashi; Yashima, Hiroshi; Baba, Mamoru; Yokobori, Hitoshi; Tahara, Yoshihisa

    2003-08-01

    To realize the accelerator-based boron neutron capture therapy (BNCT) at the Cyclotron and Radioisotope Center of Tohoku University, the feasibility of a cyclotron-based BNCT was evaluated. This study focuses on optimizing the epithermal neutron field with an energy spectrum and intensity suitable for BNCT for various combinations of neutron-producing reactions and moderator materials. Neutrons emitted at 90 degrees from a thick (stopping-length) Ta target, bombarded by 50 MeV protons of 300 microA beam current, were selected as a neutron source, based on the measurement of angular distributions and neutron energy spectra. As assembly composed of iron, AlF3/Al/6LiF, and lead was chosen as moderators, based on the simulation trials using the MCNPX code. The depth dose distributions in a cylindrical phantom, calculated with the MCNPX code, showed that, within 1 h of therapeutic time, the best moderator assembly, which is 30-cm-thick iron, 39-cm-thick AlF3/Al/6LiF, and 1-cm-thick lead, provides an epithermal neutron flux of 0.7 x 10(9) [n cm(-2) s(-1)]. This results in a tumor dose of 20.9 Gy-eq at a depth of 8 cm in the phantom, which is 6.4 Gy-eq higher than that of the Brookhaven Medical Research Reactor at the equivalent condition of maximum normal tissue tolerance. The beam power of the cyclotron is 15 kW, which is much lower than other accelerator-based BNCT proposals.

  6. Accelerator-based epithermal neutron beam design for neutron capture therapy.

    Science.gov (United States)

    Yanch, J C; Zhou, X L; Shefer, R E; Klinkowstein, R E

    1992-01-01

    Recent interest in the production of epithermal neutrons for use in boron neutron capture therapy (BNCT) has promoted an investigation into the feasibility of generating such neutrons with a high current proton accelerator. Energetic protons (2.5 MeV) on a 7Li target produce a spectrum of neutrons with maximum energy of roughly 800 keV. A number of combinations of D2O moderator, lead reflector, 6Li thermal neutron filtration, and D2O/6Li shielding will result in a useful epithermal flux of 1.6 x 10(8) n/s at the patient position. The neutron beam is capable of delivering 3000 RBE-cGy to a tumor at a depth of 7.5 cm in a total treatment time of 60-93 min (depending on RBE values used and based on a 24-cm diameter x 19-cm length D2O moderator). Treatment of deeper tumors with therapeutic advantage would also be possible. Maximum advantage depths (RBE weighted) of 8.2-9.2 (again depending on RBE values and precise moderator configuration) are obtained in a right-circular cylindrical phantom composed of brain-equivalent material with an advantage ratio of 4.7-6.3. A tandem cascade accelerator (TCA), designed and constructed at Science Research Laboratory (SRL) in Somerville MA, can provide the required proton beam parameters for BNCT of deep-seated tumors. An optimized configuration of materials required to shift the accelerator neutron spectrum down to therapeutically useful energies has been designed using Monte Carlo simulation in the Whitaker College Biomedical Imaging and Computation Laboratory at MIT. Actual construction of the moderator/reflector assembly is currently underway.

  7. Boron neutron capture therapy (BNCT): implications of neutron beam and boron compound characteristics.

    Science.gov (United States)

    Wheeler, F J; Nigg, D W; Capala, J; Watkins, P R; Vroegindeweij, C; Auterinen, I; Seppälä, T; Bleuel, D

    1999-07-01

    The potential efficacy of boron neutron capture therapy (BNCT) for malignant glioma is a significant function of epithermal-neutron beam biophysical characteristics as well as boron compound biodistribution characteristics. Monte Carlo analyses were performed to evaluate the relative significance of these factors on theoretical tumor control using a standard model. The existing, well-characterized epithermal-neutron sources at the Brookhaven Medical Research Reactor (BMRR), the Petten High Flux Reactor (HFR), and the Finnish Research Reactor (FiR-1) were compared. Results for a realistic accelerator design by the E. O. Lawrence Berkeley National Laboratory (LBL) are also compared. Also the characteristics of the compound p-Boronophenylaline Fructose (BPA-F) and a hypothetical next-generation compound were used in a comparison of the BMRR and a hypothetical improved reactor. All components of dose induced by an external epithermal-neutron beam fall off quite rapidly with depth in tissue. Delivery of dose to greater depths is limited by the healthy-tissue tolerance and a reduction in the hydrogen-recoil and incident gamma dose allow for longer irradiation and greater dose at a depth. Dose at depth can also be increased with a beam that has higher neutron energy (without too high a recoil dose) and a more forward peaked angular distribution. Of the existing facilities, the FiR-1 beam has the better quality (lower hydrogen-recoil and incident gamma dose) and a penetrating neutron spectrum and was found to deliver a higher value of Tumor Control Probability (TCP) than other existing beams at shallow depth. The greater forwardness and penetration of the HFR the FiR-1 at greater depths. The hypothetical reactor and accelerator beams outperform at both shallow and greater depths. In all cases, the hypothetical compound provides a significant improvement in efficacy but it is shown that the full benefit of improved compound is not realized until the neutron beam is fully

  8. Thick beryllium target as an epithermal neutron source for neutron capture therapy.

    Science.gov (United States)

    Wang, C K; Moore, B R

    1994-10-01

    Accelerator-based intense epithermal neutron sources for Neutron Capture Therapy (NCT) have been considered as an alternative to nuclear reactors. Lithium (Li) has generally received the widest attention for this application, since the threshold energy is low and neutron yield is high. Because of the poor thermal and chemical properties of Li and the need for heat removal in the target, the design of Li targets has been quite difficult. Beryllium (Be) has been thought of as an alternative target because of its good thermal and chemical properties and reasonable neutron yield. However, in order to have a neutron yield comparable to that of a thick Li target bombarded with 2.5 MeV protons, the proton energy required for a thick Be target must be approaching 4 MeV. Consequently, the neutrons emitted are more energetic. In addition, a significant amount of high-energy gamma rays, which is undesirable, will occur when Be is bombarded with low-energy protons. Regardless of the more energetic neutrons and additional gamma rays, in this paper it is shown that it is possible to develop a high-quality and high-intensity epithermal neutron beam based on a thick Be target for NCT treatment. For a fixed proton current, the optimal Be-target-based beam (with 4-MeV protons) can produce a neutron beam, with both quality and intensity slightly better than those produced by the optimal Li-target-based beam (with 2.5-MeV protons). The single-session NCT treatment time for the optimal Be-target-based beam is estimated to be 88 min for a proton current of 50 mA.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. First application of dynamic infrared imaging in boron neutron capture therapy for cutaneous malignant melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Santa Cruz, G. A.; Gonzalez, S. J.; Bertotti, J.; Marin, J. [Departamento de Instrumentacion y Control, Comision Nacional de Energia Atomica, Avenida del Libertador 8250, 1429 Buenos Aires (Argentina); Departamento de Instrumentacion y Control, Comision Nacional de Energia Atomica, Avenida del Libertador 8250, 1429 Buenos Aires (Argentina) and CONICET, Avenida Rivadavia 1917, 1033 Buenos Aires (Argentina); Universidad Favaloro, Solis 453, 1078 Buenos Aires (Argentina)

    2009-10-15

    Purpose: The purpose of this study is to assess the potential of dynamic infrared imaging (DIRI) as a functional, noninvasive technique for evaluating the skin acute toxicity and tumor control within the framework of the Argentine boron neutron capture therapy (BNCT) program for cutaneous malignant melanoma. Methods: Two patients enrolled in the Argentine phase I/II BNCT clinical trial for cutaneous malignant melanoma were studied with DIRI. An uncooled infrared camera, providing a video output signal, was employed to register the temperature evolution of the normal skin and tumor regions in patients subjected to a mild local cooling (cold stimulus). In order to study the spatial correlation between dose and acute skin reactions, three-dimensional representations of the superficial dose delivered to skin were constructed and cameralike projections of the dose distribution were coregistered with visible and infrared images. Results: The main erythematous reaction was observed clinically between the second and fifth week post-BNCT. Concurrently, with its clinical onset, a reactive increase above the basal skin temperature was observed with DIRI in the third week post-BNCT within regions that received therapeutic doses. Melanoma nodules appeared as highly localized hyperthermic regions. 2 min after stimulus, these regions reached a temperature plateau and increased in size. Temperature differences with respect to normal skin up to 10 deg. C were observed in the larger nodules. Conclusions: Preliminary results suggest that DIRI, enhanced by the application of cold stimuli, may provide useful functional information associated with the metabolism and vasculature of tumors and inflammatory processes related to radiation-induced changes in the skin as well. These capabilities are aimed at complementing the clinical observations and standard imaging techniques, such as CT and Doppler ultrasound.

  10. Development of the JAERI computational dosimetry system (JCDS) for boron neutron capture therapy. Cooperative research

    Energy Technology Data Exchange (ETDEWEB)

    Kumada, Hiroaki; Yamamoto, Kazuyoshi; Torii, Yoshiya; Uchiyama, Junzo [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Matsumura, Akira; Yamamoto, Tetsuya; Nose, Tadao [Tsukuba Univ., Tsukuba, Ibaraki (Japan); Nakagawa, Yoshinobu [National Sanatorium Kagawa-Children' s Hospital, Kagawa (Japan); Kageji, Teruyoshi [Tokushima Univ., Tokushima (Japan)

    2003-03-01

    The Neutron Beam Facility at JRR-4 enables us to carry out boron neutron capture therapy with epithermal neutron beam. In order to make treatment plans for performing the epithermal neutron beam BNCT, it is necessary to estimate radiation doses in a patient's head in advance. The JAERI Computational Dosimetry System (JCDS), which can estimate distributions of radiation doses in a patient's head by simulating in order to support the treatment planning for epithermal neutron beam BNCT, was developed. JCDS is a software that creates a 3-dimentional head model of a patient by using CT and MRI images, and that generates a input data file automatically for calculation of neutron flux and gamma-ray dose distributions in the brain with the Monte Carlo code MCNP, and that displays these dose distributions on the head model for dosimetry by using the MCNP calculation results. JCDS has any advantages as follows; By using CT data and MRI data which are medical images, a detail three-dimensional model of patient's head is able to be made easily. The three-dimensional head image is editable to simulate the state of a head after its surgical processes such as skin flap opening and bone removal in the BNCT with craniotomy that are being performed in Japan. JCDS can provide information for the Patient Setting System which can support to set the patient to an actual irradiation position swiftly and accurately. This report describes basic design of JCDS and functions in several processing, calculation methods, characteristics and performance of JCDS. (author)

  11. General Electric PETtrace cyclotron as a neutron source for boron neutron capture therapy

    Science.gov (United States)

    Bosko, Andrey

    This research investigates the use of a PETtrace cyclotron produced by General Electric (GE) as a neutron source for boron neutron capture therapy (BNCT). The GE PETtrace was chosen for this investigation because this type of cyclotron is popular among nuclear pharmacies and clinics in many countries; it is compact and reliable; it produces protons with energies high enough to produce neutrons with appropriate energy and fluence rate for BNCT and it does not require significant changes in design to provide neutrons. In particular, the standard PETtrace 18O target is considered. The cyclotron efficiency may be significantly increased if unused neutrons produced during radioisotopes production could be utilized for other medical modalities such as BNCT at the same time. The resulting dose from the radiation emitted from the target is evaluated using the Monte Carlo radiation transport code MCNP at several depths in a brain phantom for different scattering geometries. Four different moderating materials of various thicknesses were considered: light water, carbon, heavy water, arid Fluental(TM). The fluence rate tally was used to calculate photon and neutron dose, by applying fluence rate-to-dose conversion factors. Fifteen different geometries were considered and a 30-cm thick heavy water moderator was chosen as the most suitable for BNCT with the GE PETtrace cyclotron. According to the Brookhaven Medical Research Reactor (BMRR) protocol, the maximum dose to the normal brain is set to 12.5 RBEGy, which for the conditions of using a heavy water moderator, assuming a 60 muA beam current, would be reached with a treatment time of 258 min. Results showed that using a PETtrace cyclotron in this configuration provides a therapeutic ratio of about 2.4 for depths up to 4 cm inside a brain phantom. Further increase of beam current proposed by GE should significantly improve the beam quality or the treatment time and allow treating tumors at greater depths.

  12. A benchmark analysis of radiation flux distribution for Boron Neutron Capture Therapy of canine brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Moran, J.M.

    1992-02-01

    Calculations of radiation flux and dose distributions for Boron Neutron Capture Therapy (BNCT) of brain tumors are typically performed using sophisticated three-dimensional analytical models based on either a homogeneous approximation or a simplified few-region approximation to the actual highly-heterogeneous geometry of the irradiation volume. Such models should be validated by comparison with calculations using detailed models in which all significant macroscopic tissue heterogeneities and geometric structures are explicitly represented as faithfully as possible. This work describes a validation exercise for BNCT of canine brain tumors. Geometric measurements of the canine anatomical structures of interest for this work were performed by dissecting and examining two essentially identical Labrador Retriever heads. Chemical analyses of various tissue samples taken during the dissections were conducted to obtain measurements of elemental compositions for tissues of interest. The resulting geometry and tissue composition data were then used to construct a detailed heterogeneous calculational model of the Labrador Retriever head. Calculations of three-dimensional radiation flux distributions pertinent to BNCT were performed for the model using the TORT discrete-ordinates radiation transport code. The calculations were repeated for a corresponding volume-weighted homogeneous tissue model. Comparison of the results showed that the peak neutron and photon flux magnitudes were quite similar for the two models (within 5%), but that the spatial flux profiles were shifted in the heterogeneous model such that the fluxes in some locations away from the peak differed from the corresponding fluxes in the homogeneous model by as much as 10-20%. Differences of this magnitude can be therapeutically significant, emphasizing the need for proper validation of simplified treatment planning models.

  13. Epithermal neutron beam adoption for liver cancer treatment by boron and gadolinium neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Tetsuo [Musashi Inst. of Tech., Kawasaki, Kanagawa (Japan). Atomic Energy Research Lab

    2001-06-01

    Comparative evaluation was made on depth-dose distribution in boron neutron capture therapy (B-NCT) and gadolinium one (Gd-NCT) for the treatments of liver cancers. At present, epithermal neutron beam is expected to be applicable to the treatment of deep and widespread tumors. ICRU computational model of ADAM and EVA was used as a liver phantom loading a tumor at depth of 6 cm in its central region. Epithermal neutron beam of Musashi reactor was used as the primary neutron beam for the depth-dose calculation. Calculation was conducted using the three-dimensional continuous-energy Monte Carlo code MCNP4A. The doses observed in both NCTs were bumped over the tumor region but the dose for Gd-NCT was not so tumor-specific compared with that for BNCT because radiation in Gd-NCT was due to {gamma}-ray. The mean physical dose was 4 Gy/h for boron 30 ppm and 5 Gy/h for Gd 1000 ppm when exposed to an epithermal neutron flux of 5x10{sup 8} n/cm{sup -2}/sec and the dose ratio of tumor-to normal tissue was 2.7 for boron and 2.5 for Gd. The lethal dose of 50 Gy for the liver can be accomplished under conditions where the dose has not reached 25 Gy, the tolerance dose of the normal tissue. This seems very encouraging and indicating that both B-NCT and Gd-NCT are applicable for the treatment for liver cancer. However, if normal tissue contain 1/4 of the tumor concentration of boron or Gd, the BNCT would still possible when considering a large RBE value for {sup 10}B(n, {alpha}) reaction but the Gd-NCT would impossible for deep liver treatment. (M.N.)

  14. PEMODELAN KOLIMATOR DI RADIAL BEAM PORT REAKTOR KARTINI UNTUK BORON NEUTRON CAPTURE THERAPY

    Directory of Open Access Journals (Sweden)

    Bemby Yulio Vallenry

    2015-03-01

    Full Text Available Salah satu metode terapi kanker adalah Boron Neutron Capture Therapy (BNCT. BNCT memanfaatkan tangkapan neutron oleh 10B yang terendapkan pada sel kanker. Keunggulan BNCT dibandingkan dengan terapi radiasi lainnya adalah tingkat selektivitas yang tinggi karena tingkatannya adalah sel. Pada penelitian ini dilakukan pemodelan kolimator di radial beamport reaktor Kartini sebagai dasar pemilihan material dan manufature kolimator sebagai sumber neutron untuk BNCT. Pemodelan ini dilakukan dengan simulasi menggunakan perangkat lunak Monte Carlo N-Particle versi 5 (MCNP 5. MCNP 5 adalah suatu paket program untuk memodelkan sekaligus menghitung masalah transpor partikel dengan mengikuti sejarah hidup neutron semenjak lahir, bertranspor pada bahan hingga akhirnya hilang karena mengalami reaksi penyerapan atau keluar dari sistem. Pemodelan ini menggunakan variasi material dan ukurannya agar menghasilkan nilai dari tiap parameter-parameter yang sesuai dengan rekomendasi I International Atomic Energy Agency (IAEA untuk BNCT, yaitu fluks neutron epitermal (Фepi > 9 n.cm-2.s-1, rasio antara laju dosis neutron cepat dan fluks neutron epitermal (Ḋf/Фepi 0,7. Berdasarkan hasil optimasi dari pemodelan ini, material dan ukuran penyusun kolimator yang didapatkan yaitu 0,75 cm Ni sebagai dinding kolimator, 22 cm Al sebagai moderator dan 4,5 cm Bi sebagai perisai gamma. Keluaran berkas radiasi yang dihasilkan dari pemodelan kolimator radial beamport yaitu Фepi = 5,25 x 106 n.cm-2s-1, Ḋf/Фepi =1,17 x 10-13 Gy.cm2.n-1, Ḋγ/Фepi = 1,70 x 10-12 Gy.cm2.n-1, Фth/Фepi = 1,51 dan J/Фepi = 0,731. Berdasarkan penelitian ini, hasil optimasi 5 parameter sebagai persyaratan kolimator untuk BNCT yang keluar dari radial beam port tidak sepenuhnya memenuhi kriteria yang direkomendasikan oleh IAEA sehingga perlu dilakukan penelitian lebih lanjut agar tercapainya persyaratan IAEA. Kata kunci: BNCT, radial beamport, MCNP 5, kolimator   One of the cancer therapy methods is

  15. Early clinical experience utilizing scintillator with optical fiber (SOF) detector in clinical boron neutron capture therapy: its issues and solutions

    OpenAIRE

    Ishikawa, Masayori; Yamamoto, Tetsuya; Matsumura, Akira; Hiratsuka, Junichi; Miyatake, Shin-Ichi; Kato, Itsuro; Sakurai, Yoshinori; Kumada, Hiroaki; Shrestha, Shubhechha J.; ONO, KOJI

    2016-01-01

    Background Real-time measurement of thermal neutrons in the tumor region is essential for proper evaluation of the absorbed dose in boron neutron capture therapy (BNCT) treatment. The gold wire activation method has been routinely used to measure the neutron flux distribution in BNCT irradiation, but a real-time measurement using gold wire is not possible. To overcome this issue, the scintillator with optical fiber (SOF) detector has been developed. The purpose of this study is to demonstrate...

  16. Measurement of in-phantom neutron flux and gamma dose in Tehran research reactor boron neutron capture therapy beam line

    OpenAIRE

    Elham Bavarnegin; Alireza Sadremomtaz; Hossein Khalafi; Yaser Kasesaz

    2016-01-01

    Aim: Determination of in-phantom quality factors of Tehran research reactor (TRR) boron neutron capture therapy (BNCT) beam. Materials and Methods: The doses from thermal neutron reactions with 14N and 10B are calculated by kinetic energy released per unit mass approach, after measuring thermal neutron flux using neutron activation technique. Gamma dose is measured using TLD-700 dosimeter. Results: Different dose components have been measured in a head phantom which has been designed an...

  17. Boron neutron capture therapy design calculation of a 3H(p,n) reaction based BSA for brain cancer setup

    OpenAIRE

    Bassem Elshahat; Akhtar Naqvi; Nabil Maalej

    2015-01-01

    Purpose: Boron neutron capture therapy (BNCT) is a promising technique for the treatment of malignant disease targeting organs of the human body. Monte Carlo simulations were carried out to calculate optimum design parameters of an accelerator based beam shaping assembly (BSA) for BNCT of brain cancer setup.Methods: Epithermal beam of neutrons were obtained through moderation of fast neutrons from 3H(p,n) reaction in a high density polyethylene moderator and a graphite reflector. The dimensio...

  18. Neutron spectrum for neutron capture therapy in boron; Espectro de neutrones para terapia por captura de neutrones en boro

    Energy Technology Data Exchange (ETDEWEB)

    Medina C, D.; Soto B, T. G. [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Programa de Doctorado en Ciencias Basicas, 98068 Zacatecas, Zac. (Mexico); Baltazar R, A. [Universidad Autonoma de Zacatecas, Unidad Academica de Ingenieria Electrica, Programa de Doctorado en Ingenieria y Tecnologia Aplicada, 98068 Zacatecas, Zac. (Mexico); Vega C, H. R., E-mail: dmedina_c@hotmail.com [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Cipres No. 10, Fracc. La Penuela, 98068 Zacatecas, Zac. (Mexico)

    2016-10-15

    Glioblastoma multiforme is the most common and aggressive of brain tumors and is difficult to treat by surgery, chemotherapy or conventional radiation therapy. One treatment alternative is the Neutron Capture Therapy in Boron, which requires a beam modulated in neutron energy and a drug with {sup 10}B able to be fixed in the tumor. When the patients head is exposed to the neutron beam, they are captured by the {sup 10}B and produce a nucleus of {sup 7}Li and an alpha particle whose energy is deposited in the cancer cells causing it to be destroyed without damaging the normal tissue. One of the problems associated with this therapy is to have an epithermal neutrons flux of the order of 10{sup 9} n/cm{sup 2}-sec, whereby irradiation channels of a nuclear research reactor are used. In this work using Monte Carlo methods, the neutron spectra obtained in the radial irradiation channel of the TRIGA Mark III reactor are calculated when inserting filters whose position and thickness have been modified. From the arrangements studied, we found that the Fe-Cd-Al-Cd polyethylene filter yielded a ratio between thermal and epithermal neutron fluxes of 0.006 that exceeded the recommended value (<0.05), and the dose due to the capture gamma rays is lower than the dose obtained with the other arrangements studied. (Author)

  19. Gantry orientation effect on the neutron and capture gamma ray dose equivalent at the maze entrance door in radiation therapy

    Directory of Open Access Journals (Sweden)

    Ghiasi Hosein

    2012-01-01

    Full Text Available In the present study, the effect of gantry orientation on the photoneutron and capture gamma dose calculations for maze entrance door was evaluated. A typical radiation therapy room made of ordinary concrete was simulated using MCNPX Monte Carlo code. Gantry rotation was simulated at eight different angles around the isocenter. Both neutron and capture gamma dose vary considerably with gantry angle. The ratios of the maximum to the minimum values for neutron and capture gamma dose equivalents were 1.9 and 1.4, respectively. On the other hand, comparison of the Monte Carlo calculated mean value over all orientations with Monte Carlo calculated neutron and gamma dose showed that the Wu-McGinley method differed by 5% and 2%, respectively. However, for more conservative shielding calculations, factors of 1.6 and 1.3 should be applied to the calculated neutron and capture gamma doses at downward irradiation. Finally, it can be concluded that the gantry angle influences neutron and capture gamma dose at the maze entrance door and it should be taken into account in shielding considerations.

  20. Boron neutron capture therapy of brain tumors: past history, current status, and future potential.

    Science.gov (United States)

    Barth, R F; Soloway, A H; Brugger, R M

    1996-01-01

    Boron neutron capture therapy (BNCT) is based on the nuclear reaction that occurs when boron-10 is irradiated with low-energy thermal neutrons to yield alpha particles and recoiling lithium-7 nuclei. High-grade astrocytomas, glioblastoma multiforme, and metastatic brain tumors constitute a major group of neoplasms for which there is no effective treatment. There is growing interest in using BNCT in combination with surgery to treat patients with primary, and possibly metastatic brain tumors. For BNCT to be successful, a large number of 10B atoms must be localized on or preferably within neoplastic cells, and a sufficient number of thermal neutrons must reach and be absorbed by the 10B atoms to sustain a lethal 10B(n, alpha)7 Li reaction. Two major questions will be addressed in this review. First, how can a large number of 10B atoms be delivered selectively to cancer cells? Second, how can a high fluence of neutrons be delivered to the tumor? Two boron compounds currently are being used clinically, sodium borocaptate (BSH) and boronophenylalanine (BPA), and a number of new delivery agents are under investigation, including boronated porphyrins, nucleosides, amino acids, polyamines, monoclonal and bispecific antibodies, liposomes, and epidermal growth factor. These will be discussed, and potential problems associated with their use as boron delivery agents will be considered. Nuclear reactors, currently, are the only source of neutrons for BNCT, and the fission process within the core produces a mixture of lower-energy thermal and epithermal neutrons, fast or high (> 10,000 eV) energy neutrons, and gamma rays. Although thermal neutron beams have been used clinically in Japan to treat patients with brain tumors and cutaneous melanomas, epithermal neutron beams should be more useful because of their superior tissue-penetrating properties. Beam sources and characteristics will be discussed in the context of current and future BNCT trials. Finally, the past and present

  1. Monte Carlo based treatment planning systems for Boron Neutron Capture Therapy in Petten, The Netherlands

    Science.gov (United States)

    Nievaart, V. A.; Daquino, G. G.; Moss, R. L.

    2007-06-01

    Boron Neutron Capture Therapy (BNCT) is a bimodal form of radiotherapy for the treatment of tumour lesions. Since the cancer cells in the treatment volume are targeted with 10B, a higher dose is given to these cancer cells due to the 10B(n,α)7Li reaction, in comparison with the surrounding healthy cells. In Petten (The Netherlands), at the High Flux Reactor, a specially tailored neutron beam has been designed and installed. Over 30 patients have been treated with BNCT in 2 clinical protocols: a phase I study for the treatment of glioblastoma multiforme and a phase II study on the treatment of malignant melanoma. Furthermore, activities concerning the extra-corporal treatment of metastasis in the liver (from colorectal cancer) are in progress. The irradiation beam at the HFR contains both neutrons and gammas that, together with the complex geometries of both patient and beam set-up, demands for very detailed treatment planning calculations. A well designed Treatment Planning System (TPS) should obey the following general scheme: (1) a pre-processing phase (CT and/or MRI scans to create the geometric solid model, cross-section files for neutrons and/or gammas); (2) calculations (3D radiation transport, estimation of neutron and gamma fluences, macroscopic and microscopic dose); (3) post-processing phase (displaying of the results, iso-doses and -fluences). Treatment planning in BNCT is performed making use of Monte Carlo codes incorporated in a framework, which includes also the pre- and post-processing phases. In particular, the glioblastoma multiforme protocol used BNCT_rtpe, while the melanoma metastases protocol uses NCTPlan. In addition, an ad hoc Positron Emission Tomography (PET) based treatment planning system (BDTPS) has been implemented in order to integrate the real macroscopic boron distribution obtained from PET scanning. BDTPS is patented and uses MCNP as the calculation engine. The precision obtained by the Monte Carlo based TPSs exploited at Petten

  2. Accelerator-based epithermal neutron sources for boron neutron capture therapy of brain tumors.

    Science.gov (United States)

    Blue, Thomas E; Yanch, Jacquelyn C

    2003-01-01

    This paper reviews the development of low-energy light ion accelerator-based neutron sources (ABNSs) for the treatment of brain tumors through an intact scalp and skull using boron neutron capture therapy (BNCT). A major advantage of an ABNS for BNCT over reactor-based neutron sources is the potential for siting within a hospital. Consequently, light-ion accelerators that are injectors to larger machines in high-energy physics facilities are not considered. An ABNS for BNCT is composed of: (1) the accelerator hardware for producing a high current charged particle beam, (2) an appropriate neutron-producing target and target heat removal system (HRS), and (3) a moderator/reflector assembly to render the flux energy spectrum of neutrons produced in the target suitable for patient irradiation. As a consequence of the efforts of researchers throughout the world, progress has been made on the design, manufacture, and testing of these three major components. Although an ABNS facility has not yet been built that has optimally assembled these three components, the feasibility of clinically useful ABNSs has been clearly established. Both electrostatic and radio frequency linear accelerators of reasonable cost (approximately 1.5 M dollars) appear to be capable of producing charged particle beams, with combinations of accelerated particle energy (a few MeV) and beam currents (approximately 10 mA) that are suitable for a hospital-based ABNS for BNCT. The specific accelerator performance requirements depend upon the charged particle reaction by which neutrons are produced in the target and the clinical requirements for neutron field quality and intensity. The accelerator performance requirements are more demanding for beryllium than for lithium as a target. However, beryllium targets are more easily cooled. The accelerator performance requirements are also more demanding for greater neutron field quality and intensity. Target HRSs that are based on submerged-jet impingement and

  3. Boron neutron capture therapy induces apoptosis of glioma cells through Bcl-2/Bax

    Directory of Open Access Journals (Sweden)

    Mao Xinggang

    2010-12-01

    Full Text Available Abstract Background Boron neutron capture therapy (BNCT is an alternative treatment modality for patients with glioma. The aim of this study was to determine whether induction of apoptosis contributes to the main therapeutic efficacy of BNCT and to compare the relative biological effect (RBE of BNCT, γ-ray and reactor neutron irradiation. Methods The neutron beam was obtained from the Xi'an Pulsed Reactor (XAPR and γ-rays were obtained from [60Co] γ source of the Fourth Military Medical University (FMMU in China. Human glioma cells (the U87, U251, and SHG44 cell lines were irradiated by neutron beams at the XAPR or [60Co] γ-rays at the FMMU with different protocols: Group A included control nonirradiated cells; Group B included cells treated with 4 Gy of [60Co] γ-rays; Group C included cells treated with 8 Gy of [60Co] γ-rays; Group D included cells treated with 4 Gy BPA (p-borono-phenylalanine-BNCT; Group E included cells treated with 8 Gy BPA-BNCT; Group F included cells irradiated in the reactor for the same treatment period as used for Group D; Group G included cells irradiated in the reactor for the same treatment period as used for Group E; Group H included cells irradiated with 4 Gy in the reactor; and Group I included cells irradiated with 8 Gy in the reactor. Cell survival was determined using the 3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium (MTT cytotoxicity assay. The morphology of cells was detected by Hoechst33342 staining and transmission electron microscope (TEM. The apoptosis rate was detected by flow cytometer (FCM. The level of Bcl-2 and Bax protein was measured by western blot analysis. Results Proliferation of U87, U251, and SHG44 cells was much more strongly inhibited by BPA-BNCT than by irradiation with [60Co] γ-rays (P 60Co] γ-rays (P P Conclusions Compared with ��-ray and reactor neutron irradiation, a higher RBE can be achieved upon treatment of glioma cells with BNCT. Glioma cell apoptosis induced by

  4. Reference dosimetry calculations for neutron capture therapy with comparison of analytical and voxel models.

    Science.gov (United States)

    Goorley, J T; Kiger, W S; Zamenhof, R G

    2002-02-01

    As clinical trials of Neutron Capture Therapy (NCT) are initiated in the U.S. and other countries, new treatment planning codes are being developed to calculate detailed dose distributions in patient-specific models. The thorough evaluation and comparison of treatment planning codes is a critical step toward the eventual standardization of dosimetry, which, in turn, is an essential element for the rational comparison of clinical results from different institutions. In this paper we report development of a reference suite of computational test problems for NCT dosimetry and discuss common issues encountered in these calculations to facilitate quantitative evaluations and comparisons of NCT treatment planning codes. Specifically, detailed depth-kerma rate curves were calculated using the Monte Carlo radiation transport code MCNP4B for four different representations of the modified Snyder head phantom, an analytic, multishell, ellipsoidal model, and voxel representations of this model with cubic voxel sizes of 16, 8, and 4 mm. Monoenergetic and monodirectional beams of 0.0253 eV, 1, 2, 10, 100, and 1000 keV neutrons, and 0.2, 0.5, 1, 2, 5, and 10 MeV photons were individually simulated to calculate kerma rates to a statistical uncertainty of neutron beam with a broad neutron spectrum, similar to epithermal beams currently used or proposed for NCT clinical trials, was computed for all models. The thermal neutron, fast neutron, and photon kerma rates calculated with the 4 and 8 mm voxel models were within 2% and 4%, respectively, of those calculated for the analytical model. The 16 mm voxel model produced unacceptably large discrepancies for all dose components. The effects from different kerma data sets and tissue compositions were evaluated. Updating the kerma data from ICRU 46 to ICRU 63 data produced less than 2% difference in kerma rate profiles. The depth-dose profile data, Monte Carlo code input, kerma factors, and model construction files are available

  5. Determination and production of an optimal neutron energy spectrum for boron neutron capture therapy

    Science.gov (United States)

    Bleuel, Darren Leo

    An accelerator-based neutron irradiation facility employing an electrostatic quadrupole (ESQ) accelerator for Boron Neutron Capture Therapy (BNCT) has been proposed at Lawrence Berkeley National Laboratory. In this dissertation, the properties of an ideal neutron beam for delivering a maximized dose to a glioblastoma multiforme tumor in a reasonable time while minimizing the dose to healthy tissue is examined. A variety of materials, beam shaping assemblies, and neutron sources were considered to deliver a neutron spectrum as close to the calculated idealized spectrum as possible. Several optimization studies were performed to determine the best proton energy and moderator material to maximize the efficacy of an accelerator-based BNCT facility utilizing the 7Li(p,n)7Be reaction as a neutron source. A new, faster method of performing such an optimization was developed, known as the "Ubertally" method, in which data from a single Monte Carlo simulation is reweighted to produce results for any neutron spatial, energy and angular source distribution. Results were confirmed experimentally at Lawrence Berkeley National Laboratory's 88″ cyclotron. Thermal fluxes in this experiment were found to be approximately 30% lower than expected, but the depth-dose profile was confirmed to within 8% maximum deviation. A final beam shaping assembly is then recommended. Utilizing a material known as Fluental as a moderating material, deep-seated tumor doses 50% higher than that delivered by clinical trials at the Brookhaven Medical Research Reactor (BMRR) are predicted. The final recommended design should contain a 37 cm thickness of Fluental(TM) moderator, a 1--2 cm gamma shield, an Al2O3 reflector, a V-shaped aluminum-backed or copper-backed source with heavy water cooling, and a 13 cm lithiated polyethylene delimiter. This design would be operated at 2.4 MeV proton energy at 20 mA to conduct treatments in less than an hour and a half. However, this design may be easily altered

  6. Persistence of histoplasma in adrenals 7 years after antifungal therapy

    Directory of Open Access Journals (Sweden)

    Deepak Kothari

    2013-01-01

    Full Text Available Adrenal histoplasmosis is an uncommon cause for adrenal insufficiency. The duration of treatment for adrenal histoplasmosis is not clear. Existing treatment regimens advocate antifungals given for periods ranging from 6 months to 2 years. We report here a rare case who showed persistence of histoplasma in adrenal biopsy 7 years after being initially treated with itraconazole for 9 months. This calls for a prolonged therapy with regular review of adrenal morphology and histology in these patients.

  7. Boron Neutron Capture Therapy at the TRIGA Mark II of Pavia, Italy - The BNCT of the diffuse tumours

    Energy Technology Data Exchange (ETDEWEB)

    Altieri, S.; Bortolussi, S.; Stella, S.; Bruschi, P.; Gadan, M.A. [University of Pavia (Italy); INFN - National Institute for Nuclear Physics, of Pavia (Italy)

    2008-10-29

    The selectivity based on the B distribution rather than on the irradiation field makes Boron neutron Capture Therapy (BNCT) a valid option for the treatment of the disseminated tumours. As the range of the high LET particles is shorter than a cell diameter, the normal cells around the tumour are not damaged by the reactions occurring in the tumoral cells. PAVIA 2001: first treatment of multiple hepatic metastases from colon ca by BNCT and auto-transplantation technique: TAOrMINA project. The liver was extracted after BPA infusion, irradiated in the Thermal Column of the Pavia TRIGA Mark II reactor, and re-implanted in the patient. Two patients were treated, demonstrating the feasibility of the therapy and the efficacy in destroying the tumoral nodules sparing the healthy tissues. In the last years, the possibility of applying BNCT to the lung tumours using epithermal collimated neutron beams and without explanting the organ, is being explored. The principal obtained results of the BNCT research are presented, with particular emphasis on the following aspects: a) the project of a new thermal column configuration to make the thermal neutron flux more uniform inside the explanted liver, b) the Monte Carlo study by means of the MCNP code of the thermal neutron flux distribution inside a patient's thorax irradiated with epithermal neutrons, and c) the measurement of the boron concentration in tissues by (n,{alpha}) spectroscopy and neutron autoradiography. The dose distribution in the thorax are simulated using MCNP and the anthropomorphic model ADAM. To have a good thermal flux distribution inside the lung epithermal neutrons must be used, which thermalize crossing the first tissue layers. Thermal neutrons do not penetrate and the obtained uniformity is poor. In the future, the construction of a PGNAA facility using a horizontal channel of the TRIGA Mark II is planned. With this method the B concentration can be measured also in liquid samples (blood, urine) and

  8. A coupled deterministic/stochastic method for computing neutron capture therapy dose rates

    Science.gov (United States)

    Hubbard, Thomas Richard

    Neutron capture therapy (NCT) is an experimental method of treating brain tumors and other cancers by: (1) injecting or infusing the patient with a tumor-seeking, neutron target-labeled drug; and (2) irradiating the patient in an intense epithermal neutron fluence. The nuclear reaction between the neutrons and the target nuclei (e.g. sp{10}B(n,alpha)sp7Lirbrack releases energy in the form of high-LET (i.e. energy deposited within the range of a cell diameter) reaction particles which selectively kill the tumor cell. The efficacy of NCT is partly dependent on the delivery of maximum thermal neutron fluence to the tumor and the minimization of radiation dose to healthy tissue. Since the filtered neutron source (e.g. research reactor) usually provides a broad energy spectrum of highly-penetrating neutron and gamma-photon radiation, detailed transport calculations are necessary in order to plan treatments that use optimal treatment facility configurations and patient positioning. Current computational methods for NCT use either discrete ordinates calculation or, more often, Monte Carlo simulation to predict neutron fluences in the vicinity of the tumor. These methods do not, however, accurately calculate the transport of radiation throughout the entire facility or the deposition of dose in all the various parts of the body due to shortcomings of using either method alone. A computational method, specifically designed for NCT problems, has been adapted from the MASH methodology and couples a forward discrete ordinates (Ssb{n}) calculation with an adjoint Monte Carlo run to predict the dose at any point within the patient. The transport from the source through the filter/collimator is performed with a forward DORT run, and this is then coupled to adjoint MORSE results at a selected coupling parallelepiped which surrounds human phantom. Another routine was written to allow the user to generate the MORSE models at various angles and positions within the treatment room. The

  9. Boron-Containing Compounds for Liposome-Mediated Tumor Localization and Application to Neutron Capture Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hawthorne, M. Frederick [Univ. of California, Los Angeles, CA (United States)

    2005-04-07

    Medical application of boron neutron capture therapy (BNCT) has been significantly hindered by the slow development of boron drug-targeting methodologies for the selective delivery of high boron concentration sto malignant cells. We have successfully sought to fill this need by creating liposomes suitable as in vivo boron delivery vehicles for BNCT. Delivery of therapeutic quantities of boron to tumors in murine models has been achieved with small unilamellar boron-rich liposomes. Subsequently, attempts have been made to improve delivery efficiency of liposomes encapsulating boron-containing water-soluble species into their hollow core by incorporating lipophilic boron compounds as addenda to the liposome bilayer, incorporating boron compounds as structural components of the bilayer (which however, poses the risk of sacrificing some stability), and combinations thereof. Regardless of the method, approximately 90% of the total liposome mass remains therapeutically inactive and comprised of the vehicle's construction materials, while less than 5% is boron for neutron targeting. Following this laboratory's intensive study, the observed tumor specificity of certain liposomes has been attributed to their diminutive size of these liposomes (30-150 nm), which enables these small vesicles to pass through the porous, immature vasculature of rapidly growing tumor tissue. We surmised that any amphiphilic nanoparticle of suitable size could possess some tumor selectivity. Consequently, the discovery of a very boron-rich nanoparticle delivery agent with biodistribution performance similar to unilamellar liposomes became one of our goals. Closomers, a new class of polyhedral borane derivatives, attracted us as an alternative BNCT drug-delivery system. We specifically envisioned dodeca (nido-carboranyl)-substituted closomers as possibly having a great potential role in BNCT drug delivery. They could function as extraordinarily boron-rich BNCT drugs since they are

  10. Tumor growth suppression by gadolinium-neutron capture therapy using gadolinium-entrapped liposome as gadolinium delivery agent.

    Science.gov (United States)

    Dewi, Novriana; Yanagie, Hironobu; Zhu, Haito; Demachi, Kazuyuki; Shinohara, Atsuko; Yokoyama, Kazuhito; Sekino, Masaki; Sakurai, Yuriko; Morishita, Yasuyuki; Iyomoto, Naoko; Nagasaki, Takeshi; Horiguchi, Yukichi; Nagasaki, Yukio; Nakajima, Jun; Ono, Minoru; Kakimi, Kazuhiro; Takahashi, Hiroyuki

    2013-07-01

    Neutron capture therapy (NCT) is a promising non-invasive cancer therapy approach and some recent NCT research has focused on using compounds containing gadolinium as an alternative to currently used boron-10 considering several advantages that gadolinium offers compared to those of boron. In this study, we evaluated gadolinium-entrapped liposome compound as neutron capture therapy agent by in vivo experiment on colon-26 tumor-bearing mice. Gadolinium compound were injected intravenously via tail vein and allowed to accumulate into tumor site. Tumor samples were taken for quantitative analysis by ICP-MS at 2, 12, and 24 h after gadolinium compound injection. Highest gadolinium concentration was observed at about 2 h after gadolinium compound injection with an average of 40.3 μg/g of wet tumor tissue. We performed neutron irradiation at JRR-4 reactor facility of Japan Atomic Energy Research Institute in Tokaimura with average neutron fluence of 2×10¹² n/cm². The experimental results showed that the tumor growth suppression of gadolinium-injected irradiated group was revealed until about four times higher compared to the control group, and no significant weight loss were observed after treatment suggesting low systemic toxicity of this compound. The gadolinium-entrapped liposome will become one of the candidates for Gd delivery system on NCT.

  11. Implant therapy: 40 years of experience

    OpenAIRE

    Quirynen, Marc; Herrera, David; Teughels, Wim; Sanz, Mariano

    2014-01-01

    Implant placement has become a well-established and highly successful therapy in the rehabilitation of partially and fully edentulous patients. The 'original' treatment protocol, which aimed to demonstrate implant 'biocompatibility' and the achievement of osseointegration, has evolved over the past 40 years into a broader treatment approach in which the esthetic and patient-related objectives have become the main focus. This volume of Periodontology 2000 summarizes, via narrative reviews, the...

  12. Boron neutron capture therapy (BNCT) for glioblastoma multiforme using the epithermal neutron beam at the Brookhaven Medical Research Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Capala, J. [Brookhaven National Lab., Upton, NY (United States); Diaz, A.Z.; Chadha, M. [Univ. Hospital, State Univ. of New York, NY (United States)] [and others

    1997-12-31

    The abstract describes evaluation of boron neutron capture therapy (BNCT) for two groups of glioblastoma multiforme patients. From September 1994 to February 1996 15 patients have been treated. In September 1997 another 34 patients were examined. Authors determined a safe starting dose for BNCT using epithermal neutrons and BPA-F. They have also evaluated adverse effects of BNCT at this starting dose. Therapeutic effectiveness of this starting dose has been evaluated. No significant side effects from BPA-F infusion or BNCT treatment were observed in normal brains.

  13. Molecular Medicine: Synthesis and In Vivo Detection of Agents for use in Boron Neutron Capture Therapy. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Kabalka, G. W.

    2005-06-28

    The primary objective of the project was the development of in vivo methods for the detection and evaluation of tumors in humans. The project was focused on utilizing positron emission tomography (PET) to monitor the distribution and pharamacokinetics of a current boron neutron capture therapy (BNCT) agent, p-boronophenylalanine (BPA) by labeling it with a fluorine-18, a positron emitting isotope. The PET data was then used to develop enhanced treatment planning protocols. The study also involved the synthesis of new tumor selective BNCTagents that could be labeled with radioactive nuclides for the in vivo detection of boron.

  14. Biodistribution of Amine-Amide Chlorin e6 Derivative Conjugate with a Boron Nanoparticle for Boron Neutron-Capture Therapy

    OpenAIRE

    А.B. Volovetsky; N.Y. Shilyagina; V.V. Dudenkova; S.О. Pasynkova; М.А. Grin; А.F. Mironov; А.V. Feofanov; I.V. Balalaeva; А.V. Maslennikova

    2016-01-01

    The aim of the investigation was to study the biodistribution of amino-amide chlorin e6 derivative conjugate with cobalt bis-dicarbollide as a potential boron transporter for the tasks of boron neutron-capture therapy. Materials and Methods. The experiments were carried out on Balb/c mice with induced murine colon carcinoma CT-26. Amino-amide chlorin e6 derivative conjugate with cobalt bis-dicarbollide was administered intravenously, the dose being 5 and 10 mg/kg body mass. The sampling for m...

  15. Capture of gray wolves in the Kanuti Refuge: Initiation of a five-year study

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Fourteen wolves in 5 packs were captured and fitted with radio-collars in or near the Kanuti National Wildlife Refuge between 18 and 21 March 1990. There may be as...

  16. Advances in boron neutron capture therapy (BNCT) at kyoto university - From reactor-based BNCT to accelerator-based BNCT

    Science.gov (United States)

    Sakurai, Yoshinori; Tanaka, Hiroki; Takata, Takushi; Fujimoto, Nozomi; Suzuki, Minoru; Masunaga, Shinichiro; Kinashi, Yuko; Kondo, Natsuko; Narabayashi, Masaru; Nakagawa, Yosuke; Watanabe, Tsubasa; Ono, Koji; Maruhashi, Akira

    2015-07-01

    At the Kyoto University Research Reactor Institute (KURRI), a clinical study of boron neutron capture therapy (BNCT) using a neutron irradiation facility installed at the research nuclear reactor has been regularly performed since February 1990. As of November 2014, 510 clinical irradiations were carried out using the reactor-based system. The world's first accelerator-based neutron irradiation system for BNCT clinical irradiation was completed at this institute in early 2009, and the clinical trial using this system was started in 2012. A shift of BCNT from special particle therapy to a general one is now in progress. To promote and support this shift, improvements to the irradiation system, as well as its preparation, and improvements in the physical engineering and the medical physics processes, such as dosimetry systems and quality assurance programs, must be considered. The recent advances in BNCT at KURRI are reported here with a focus on physical engineering and medical physics topics.

  17. Prone Breast Intensity Modulated Radiation Therapy: 5-Year Results

    Energy Technology Data Exchange (ETDEWEB)

    Osa, Etin-Osa O.; DeWyngaert, Keith [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States); Roses, Daniel [Department of Surgery, New York University School of Medicine, New York, New York (United States); Speyer, James [Department of Medical Oncology, New York University School of Medicine, New York, New York (United States); Guth, Amber; Axelrod, Deborah [Department of Surgery, New York University School of Medicine, New York, New York (United States); Fenton Kerimian, Maria [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States); Goldberg, Judith D. [Department of Population Health, New York University School of Medicine, New York, New York (United States); Formenti, Silvia C., E-mail: Silvia.formenti@nyumc.org [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States)

    2014-07-15

    Purpose: To report the 5-year results of a technique of prone breast radiation therapy delivered by a regimen of accelerated intensity modulated radiation therapy with a concurrent boost to the tumor bed. Methods and Materials: Between 2003 and 2006, 404 patients with stage I-II breast cancer were prospectively enrolled into 2 consecutive protocols, institutional trials 03-30 and 05-181, that used the same regimen of 40.5 Gy/15 fractions delivered to the index breast over 3 weeks, with a concomitant daily boost to the tumor bed of 0.5 Gy (total dose 48 Gy). All patients were treated after segmental mastectomy and had negative margins and nodal assessment. Patients were set up prone: only if lung or heart volumes were in the field was a supine setup attempted and chosen if found to better spare these organs. Results: Ninety-two percent of patients were treated prone, 8% supine. Seventy-two percent had stage I, 28% stage II invasive breast cancer. In-field lung volume ranged from 0 to 228.27 cm{sup 3}, mean 19.65 cm{sup 3}. In-field heart volume for left breast cancer patients ranged from 0 to 21.24 cm{sup 3}, mean 1.59 cm{sup 3}. There was no heart in the field for right breast cancer patients. At a median follow-up of 5 years, the 5-year cumulative incidence of isolated ipsilateral breast tumor recurrence was 0.82% (95% confidence interval [CI] 0.65%-1.04%). The 5-year cumulative incidence of regional recurrence was 0.53% (95% CI 0.41%-0.69%), and the 5-year overall cumulative death rate was 1.28% (95% CI 0.48%-3.38%). Eighty-two percent (95% CI 77%-85%) of patients judged their final cosmetic result as excellent/good. Conclusions: Prone accelerated intensity modulated radiation therapy with a concomitant boost results in excellent local control and optimal sparing of heart and lung, with good cosmesis. Radiation Therapy Oncology Group protocol 1005, a phase 3, multi-institutional, randomized trial is ongoing and is evaluating the equivalence of a similar dose and

  18. Synthesis and biological evaluation of new boron-containing chlorin derivatives as agents for both photodynamic therapy and boron neutron capture therapy of cancer.

    Science.gov (United States)

    Asano, Ryuji; Nagami, Amon; Fukumoto, Yuki; Miura, Kaori; Yazama, Futoshi; Ito, Hideyuki; Sakata, Isao; Tai, Akihiro

    2014-03-01

    New boron-containing chlorin derivatives 9 and 13 as agents for both photodynamic therapy (PDT) and boron neutron capture therapy (BNCT) of cancer were synthesized from photoprotoporphyrin IX dimethyl ester (2) and L-4-boronophenylalanine-related compounds. The in vivo biodistribution and clearance of 9 and 13 were investigated in tumor-bearing mice. The time to maximum accumulation of compound 13 in tumor tissue was one-fourth of that of compound 9, and compound 13 showed rapid clearance from normal tissues within 24h after injection. The in vivo therapeutic efficacy of PDT using 13 was evaluated by measuring tumor growth rates in tumor-bearing mice with 660 nm light-emitting diode irradiation at 3h after injection of 13. Tumor growth was significantly inhibited by PDT using 13. These results suggested that 13 might be a good candidate for both PDT and BNCT of cancer.

  19. The radiobiological principles of boron neutron capture therapy: A critical review

    Energy Technology Data Exchange (ETDEWEB)

    Hopewell, J.W., E-mail: john.hopewell@gtc.ox.ac.uk [Green Templeton College and Particle Therapy Cancer Research Institute, University of Oxford, Oxford (United Kingdom); Morris, G.M. [Medical Department, Brookhaven National Laboratory, Upton, NY (United States); Schwint, A. [Department of Radiobiology, Constituyentes Atomic Center, National Atomic Energy Commission, San Martin, Buenos Aires (Argentina); Coderre, J.A. [Ora Inc, 300 Brickstone Square, Andover, MA (United States)

    2011-12-15

    The radiobiology of the dose components in a BNCT exposure is examined. The effect of exposure time in determining the biological effectiveness of {gamma}-rays, due to the repair of sublethal damage, has been largely overlooked in the application of BNCT. Recoil protons from fast neutrons vary in their relative biological effectiveness (RBE) as a function of energy and tissue endpoint. Thus the energy spectrum of a beam will influence the RBE of this dose component. Protons from the neutron capture reaction in nitrogen have not been studied but in practice protons from nitrogen capture have been combined with the recoil proton contribution into a total proton dose. The relative biological effectiveness of the products of the neutron capture reaction in boron is derived from two factors, the RBE of the short range particles and the bio-distribution of boron, referred to collectively as the compound biological effectiveness factor. Caution is needed in the application of these factors for different normal tissues and tumors. - Highlights: Black-Right-Pointing-Pointer Radiobiological properties of different dose components in BNCT are considered. Black-Right-Pointing-Pointer Effectiveness of {gamma}-ray dose depends strongly on exposure time due to sublethal damage repair. Black-Right-Pointing-Pointer Effectiveness of fast neutron dose depends on neutron energy spectrum. Black-Right-Pointing-Pointer {gamma}-ray and fast neutron characteristics vary between beams and thus weighting factors will differ. Black-Right-Pointing-Pointer Weighing factors for boron dose depend on the carrier, the tissue and its mode of administration.

  20. Conceptual study of a compact accelerator-driven neutron source for radioisotope production, boron neutron capture therapy and fast neutron therapy

    CERN Document Server

    Angelone, M; Rollet, S

    2002-01-01

    The feasibility of a compact accelerator-driven device for the generation of neutron spectra suitable for isotope production by neutron capture, boron neutron capture therapy and fast neutron therapy, is analyzed by Monte Carlo simulations. The device is essentially an extension of the activator proposed by Rubbia left bracket CERN/LHC/97-04(EET) right bracket , in which fast neutrons are diffused and moderated within a properly sized lead block. It is shown that by suitable design of the lead block, as well as of additional elements of moderating and shielding materials, one can generate and exploit neutron fluxes with the spectral features required for the above applications. The linear dimensions of the diffusing-moderating device can be limited to about 1 m. A full-scale device for all the above applications would require a fast neutron source of about 10**1**4 s**-**1, which could be produced by a 1 mA, 30 MeV proton beam impinging on a Be target. The concept could be tested at the Frascati Neutron Gener...

  1. Electroconvulsive Therapy and Corpus Callosum Aplasia: A 3-Year Followup

    Directory of Open Access Journals (Sweden)

    Ulrich Palm

    2011-01-01

    Full Text Available Electroconvulsive Therapy (ECT is a powerful treatment option in severe or chronic catatonic states and has been reported to be useful in oligophrenic patients. We report the followup medical history of a patient with corpus callosum aplasia (or agenesis who was continuously treated with ECT over three years. First, he improved considerably after a series of ECT, but relapses of catatonia made a continuous, weekly ECT necessary. Due to the severity of the brain malformation, an add-on medication with benzodiazepines and second generation antipsychotics was necessary to treat catatonic symptoms. This case emphasises the benefits of long-term ECT in oligophrenic patients.

  2. GPU-based prompt gamma ray imaging from boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Do-Kun; Jung, Joo-Young; Suh, Tae Suk [College of Medicine, Catholic University of Korea, Seoul (Korea, Republic of)

    2015-05-15

    This reaction can be applied to the therapy and diagnosis about the tumor simultaneously. After the compound labeled with the boron is accumulated at the tumor site, the alpha particle induced by the reaction between the thermal neutron and the boron induces tumor cell death. Also, the 478 keV prompt gamma ray is emitted from the same reaction point. If this single prompt photon is detected by single photon emission computed tomography (SPECT), the tomographic image of the therapy region can be monitored during the radiation treatment. However, in order to confirm the therapy region using the image during the treatment, the image needs to be provided promptly. Due to a relatively long acquisition time required to get SPECT images, both reduced number of projections and the fast image reconstruction schemes are needed to provide the images during radiation treatment. The computation time for image reconstruction using the GPU with the modified OSEM algorithm was measured and compared with the computation time using CPU. Through the results, we confirmed the feasibility of the image reconstruction for prompt gamma ray image using GPU for the BNCT. In the further study, the development of the algorithm for faster reconstruction of the prompt gamma ray image during the BNCT using the GPU computation will be conducted. Also, the analysis of the target to background level about the reconstructed image will be performed using the extracted image profile.

  3. Conceptual design of an RFQ accelerator-based neutron source for boron neutron-capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Wangler, T.P.; Stovall, J.E.; Bhatia, T.S.; Wang, C.K.; Blue, T.E.; Gahbauer, R.A.

    1989-01-01

    We present a conceptual design of a low-energy neutron generator for treatment of brain tumors by boron neutron capture theory (BNCT). The concept is based on a 2.5-MeV proton beam from a radio-frequency quadrupole (RFQ) linac, and the neutrons are produced by the /sup 7/Li(p,n)/sup 7/Be reaction. A liquid lithium target and modulator assembly are designed to provide a high flux of epithermal neutrons. The patient is administered a tumor-specific /sup 10/Be-enriched compound and is irradiated by the neutrons to create a highly localized dose from the reaction /sup 10/B(n,..cap alpha..)/sup 7/Li. An RFQ accelerator-based neutron source for BNCT is compact, which makes it practical to site the facility within a hospital. 11 refs., 5 figs., 1 tab.

  4. MAGIC polymer gel for dosimetric verification in boron neutron capture therapy.

    Science.gov (United States)

    Uusi-Simola, Jouni; Heikkinen, Sami; Kotiluoto, Petri; Serén, Tom; Seppälä, Tiina; Auterinen, Iiro; Savolainen, Sauli

    2007-04-30

    Radiation sensitive polymer gels are among the most promising three-dimensional dose verification tools developed to date. Polymer gel dosimeter known by the acronym MAGIC has been tested for evaluation of its use in boron neutron capture (BNCT) dosimetry. We irradiated a large (diameter 10 cm, length 20 cm) cylindrical gel phantom in the epithermal neutron beam of the Finnish BNCT facility at the FiR 1 nuclear reactor. Neutron irradiation was simulated with a Monte Carlo radiation transport code MCNP. Gel samples from the same production batch were also irradiated with 6 MV photons from a medical linear accelerator to compare dose response in the two different types of beams. Irradiated gel phantoms were imaged using MRI to determine their relaxation rate R2 maps. The measured and normalized dose distribution in the epithermal neutron beam was compared to the dose distribution calculated by computer simulation. The results support the feasibility MAGIC gel in BNCT dosimetry.

  5. Computational characterization and experimental validation of the thermal neutron source for neutron capture therapy research at the University of Missouri

    Energy Technology Data Exchange (ETDEWEB)

    Broekman, J. D. [University of Missouri, Research Reactor Center, 1513 Research Park Drive, Columbia, MO 65211-3400 (United States); Nigg, D. W. [Idaho National Laboratory, PO Box 1625, Idaho Falls, ID 83415 (United States); Hawthorne, M. F. [University of Missouri, International Institute of Nano and Molecular Medicine, 1514 Research Park Dr., Columbia, MO 65211-3450 (United States)

    2013-07-01

    Parameter studies, design calculations and neutronic performance measurements have been completed for a new thermal neutron beamline constructed for neutron capture therapy cell and small-animal radiobiology studies at the University of Missouri Research Reactor. The beamline features the use of single-crystal silicon and bismuth sections for neutron filtering and for reduction of incident gamma radiation. The computational models used for the final beam design and performance evaluation are based on coupled discrete-ordinates and Monte Carlo techniques that permit detailed modeling of the neutron transmission properties of the filtering crystals with very few approximations. Validation protocols based on neutron activation spectrometry measurements and rigorous least-square adjustment techniques show that the beam produces a neutron spectrum that has the anticipated level of thermal neutron flux and a somewhat higher than expected, but radio-biologically insignificant, epithermal neutron flux component. (authors)

  6. Optimization of the Epithermal Neutron Beam for Boron Neutron Capture Therapy at the Brookhaven Medical Research Reactor

    Science.gov (United States)

    Hu, Jih-Perng; Rorer, David C.; Reciniello, Richard N.; Holden, Norman E.

    2003-06-01

    Clinical trials of Boron Neutron Capture Therapy for patients with malignant brain tumor had been carried out for half a decade, using an epithermal neutron beam at the Brookhaven Medical Reactor. The decision to permanently close this reactor in 2000 cut short the efforts to implement a new conceptual design to optimize this beam in preparation for use with possible new protocols. Details of the conceptual design to produce a higher intensity, more forward-directed neutron beam with less contamination from gamma rays, fast and thermal neutrons are presented here for their potential applicability to other reactor facilities. Monte Carlo calculations were used to predict the flux and absorbed dose produced by the proposed design. The results were benchmarked by the dose rate and flux measurements taken at the facility then in use.

  7. Optimization of the epithermal neutron beam for Boron Neutron Capture Therapy at the Brookhaven Medical Research Reactor.

    Science.gov (United States)

    Hu, Jih-Perng; Reciniello, Richard N; Holden, Norman E

    2004-05-01

    The use of epithermal neutron beam in clinical trials of Boron Neutron Capture Therapy for patients with malignant brain tumors had been carried out for half a decade at the Brookhaven's Medical Reactor. The decision to permanently close this reactor in 2000 cut short the efforts to implement a new conceptual design to optimize this beam in preparation for use with possible new BNCT protocols. Details of the conceptual design to produce a highly intensified and focused neutron beam with less gamma and neutron contamination in tissues are presented here for their potential applicability to other reactor facilities. Neutron-photon coupled Monte Carlo calculations were used to predict the flux, current, heating, and absorbed dose produced by the proposed design. The results were benchmarked by the dose rate and flux measurements taken at the facility then in use.

  8. Self-shielding effects in neutron spectra measurements for neutron capture therapy by means of activation foils.

    Science.gov (United States)

    Pytel, Krzysztof; Józefowicz, Krystyna; Pytel, Beatrycze; Koziel, Alina

    2004-01-01

    The design and optimisation of a neutron beam for neutron capture therapy (NCT) is accompanied by the neutron spectra measurements at the target position. The method of activation detectors was applied for the neutron spectra measurements. Epithermal neutron energy region imposes the resonance structure of activation cross sections resulting in strong self-shielding effects. The neutron self-shielding correction factor was calculated using a simple analytical model of a single absorption event. Such a procedure has been applied to individual cross sections from pointwise ENDF/B-VI library and new corrected activation cross sections were introduced to a spectra unfolding algorithm. The method has been verified experimentally both for isotropic and for parallel neutron beams. Two sets of diluted and non-diluted activation foils covered with cadmium were irradiated in the neutron field. The comparison of activation rates of diluted and non-diluted foils has demonstrated the correctness of the applied self-shielding model.

  9. Investigation of Dose Distribution in Mixed Neutron-Gamma Field of Boron Neutron Capture Therapy using N-Isopropylacrylamide Gel

    Directory of Open Access Journals (Sweden)

    Elham Bavarnegin

    2017-02-01

    Full Text Available Gel dosimeters have unique advantages in comparison with other dosimeters. Until now, these gels have been used in different radiotherapy techniques as a reliable dosimetric tool. Because dose distribution measurement is an important factor for appropriate treatment planning in different radiotherapy techniques, in this study, we evaluated the ability of the N-isopropylacrylamide (NIPAM polymer gel to record the dose distribution resulting from the mixed neutron-gamma field of boron neutron capture therapy (BNCT. In this regard, a head phantom containing NIPAM gel was irradiated using the Tehran Research Reactor BNCT beam line, and then by a magnetic resonance scanner. Eventually, the R2 maps were obtained in different slices of the phantom by analyzing T2-weighted images. The results show that NIPAM gel has a suitable potential for recording three-dimensional dose distribution in mixed neutron-gamma field dosimetry.

  10. Functionalization and cellular uptake of boron carbide nanoparticles. The first step toward T cell-guided boron neutron capture therapy.

    Science.gov (United States)

    Mortensen, M W; Björkdahl, O; Sørensen, P G; Hansen, T; Jensen, M R; Gundersen, H J G; Bjørnholm, T

    2006-01-01

    In this paper we present surface modification strategies of boron carbide nanoparticles, which allow for bioconjugation of the transacting transcriptional activator (TAT) peptide and fluorescent dyes. Coated nanoparticles can be translocated into murine EL4 thymoma cells and B16 F10 malignant melanoma cells in amounts as high as 0.3 wt. % and 1 wt. %, respectively. Neutron irradiation of a test system consisting of untreated B16 cells mixed with B16 cells loaded with boron carbide nanoparticles were found to inhibit the proliferative capacity of untreated cells, showing that cells loaded with boron-containing nanoparticles can hinder the growth of neighboring cells upon neutron irradiation. This could provide the first step toward a T cell-guided boron neutron capture therapy.

  11. Studies for the application of boron neutron capture therapy to the treatment of differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dagrosa, A., E-mail: dagrosa@cnea.gov.ar [Department of Radiobiology, National Atomic Energy Commission (CNEA), Av General Paz 1499, San Martin (1560) (Argentina)] [National Research Council of Argentina (CONICET), Rivadavia 1917, (1033) Buenos Aires (Argentina); Carpano, M. [Department of Radiobiology, National Atomic Energy Commission (CNEA), Av General Paz 1499, San Martin (1560) (Argentina); Perona, M. [Department of Radiobiology, National Atomic Energy Commission (CNEA), Av General Paz 1499, San Martin (1560) (Argentina)] [National Research Council of Argentina (CONICET), Rivadavia 1917, (1033) Buenos Aires (Argentina); Thomasz, L. [Department of Radiobiology, National Atomic Energy Commission (CNEA), Av General Paz 1499, San Martin (1560) (Argentina); Nievas, S. [Department of Chemistry, National Atomic Energy Commission (CNEA), Av General Paz 1499, San Martin (1560) (Argentina); Cabrini, R. [Department of Radiobiology, National Atomic Energy Commission (CNEA), Av General Paz 1499, San Martin (1560) (Argentina); Juvenal, G. [Department of Radiobiology, National Atomic Energy Commission (CNEA), Av General Paz 1499, San Martin (1560) (Argentina)] [National Research Council of Argentina (CONICET), Rivadavia 1917, (1033) Buenos Aires (Argentina); Pisarev, M. [Department of Radiobiology, National Atomic Energy Commission (CNEA), Av General Paz 1499, San Martin (1560) (Argentina)] [National Research Council of Argentina (CONICET), Rivadavia 1917, (1033) Buenos Aires (Argentina)] [Department of Biochemistry, UBA School of Medicine (Argentina)

    2011-12-15

    The aim of these studies was to evaluate the possibility of treating differentiated thyroid cancer by BNCT. These carcinomas are well controlled with surgery followed by therapy with {sup 131}I; however, some patients do not respond to this treatment. BPA uptake was analyzed both in vitro and in nude mice implanted with cell lines of differentiated thyroid carcinoma. The boron intracellular concentration in the different cell lines and the biodistribution studies showed the selectivity of the BPA uptake by this kind of tumor.

  12. Promising cancer treatment modality: the University of California Davis/McClellan Nuclear Radiation Center neutron capture therapy program

    Science.gov (United States)

    Autry-Conwell, Susan A.; Boggan, James E.; Edwards, Benjamin F.; Hou, Yongjin; Vincente, Maria-Graca; Liu, Hungyuan; Richards, Wade J.

    2000-12-01

    Neutron capture therapy (NCT) is a promising new binary therapeutic modality for the treatment of localized tumors. It is accomplished by injection and localization within the tumor of a neutron capture agent (NCA) that alone, is non- toxic. Whenthe tumor is then exposed to neutrons, a relatively non-toxic form of radiation, crytotoxic products are produced that directly or indirectly cause tumor cell death, and yet preserves normal surrounding tissue not contain the NCA. The UC Davis NCT program is currently working to develop and test new compounds or NCA in vitro and in vivo. Many groups worldwide are also working to develop the next generation NCA, but less than five facilities internationally are currently capable to treating clinical brain tumor patients by NCT and only two US facilities, MIT and Brookhaven National Laboratory. In addition to compound development, the UC Davis NCT program is preparing the UC Davis McClellan Nuclear Radiation Center's 2 megawatt TRIGA reactor for NCT clinical trials which would make it the only such facility on the West Coast.

  13. Dose point kernel for boron-11 decay and the cellular S values in boron neutron capture therapy.

    Science.gov (United States)

    Ma, Yunzhi; Geng, JinPeng; Gao, Song; Bao, Shanglian

    2006-12-01

    The study of the radiobiology of boron neutron capture therapy is based on the cellular level dosimetry of boron-10's thermal neutron capture reaction 10B(n,alpha)7Li, in which one 1.47 MeV helium-4 ion and one 0.84 MeV lithium-7 ion are spawned. Because of the chemical preference of boron-10 carrier molecules, the dose is heterogeneously distributed in cells. In the present work, the (scaled) dose point kernel of boron-11 decay, called 11B-DPK, was calculated by GEANT4 Monte Carlo simulation code. The DPK curve drops suddenly at the radius of 4.26 microm, the continuous slowing down approximation (CSDA) range of a lithium-7 ion. Then, after a slight ascending, the curve decreases to near zero when the radius goes beyond 8.20 microm, which is the CSDA range of a 1.47 MeV helium-4 ion. With the DPK data, S values for nuclei and cells with the boron-10 on the cell surface are calculated for different combinations of cell and nucleus sizes. The S value for a cell radius of 10 microm and a nucleus radius of 5 microm is slightly larger than the value published by Tung et al. [Appl. Radiat. Isot. 61, 739-743 (2004)]. This result is potentially more accurate than the published value since it includes the contribution of a lithium-7 ion as well as the alpha particle.

  14. Considerations for boron neutron capture therapy studies; Consideracoes sobre o estudo da BNCT (terapia de captura neutronica por boro)

    Energy Technology Data Exchange (ETDEWEB)

    Faria Gaspar, P. de

    1994-12-31

    Radiotherapy is indispensable as a mean to eradicate deeply or infiltrating tumor tissue that can not be removed surgically. Therefore, it is not selective and may also kill the surrounding health tissue. The principle of BNCT (Boron Neutron Capture Therapy) consist in targeting a tumor selectively with a boron-10 compound. This nuclide has a large capture cross section for thermal neutrons and the nuclear reaction and the delivered energy in locus will selective the tumor. Since its initial proposal in 1963 BNCT has made much progress, however it is not used in a routine treatment. In this work it was approached some complex procedures, as the obtention of selective boron compounds, the adequate set up of neutron beams, the biodistribution, the in vivo and in vitro studies, and also human patients treatments. This work provide fundamentals about BNCT to professional of different areas of knowledge since it comprises multidisciplinary study. It includes appendixes for the ones not related to the field for a better comprehension of the many aspects involved. It is also presented a glossary containing technical and basic aspects involved. It is also presented a glossary containing technical and basic terms referred in the work. (author). 174 refs, 1 fig, 12 apps.

  15. Investigation of current status in Europe and USA on boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-11-01

    This report describes on the spot investigation results of current status of medical irradiation in Europe and USA at Feb. 1999. In HFR (Netherlands), the phase 1 study with the Joint Research Centre (JRC) of the EU had been already finished in those days, at the same time, an improvement of medical irradiation field of VTT(Finland) had been finishing and then clinical trial research had been about to start. On the other hand, phase 1 studies by two groups of BNL (Brook heaven National Laboratory) and MIT (Nuclear Engineering of Massachusetts Institute of Technology) in US were now in almost final stage, and they would start on phase 2 study. Either reactors of MIT and BNL were in modification to increase neutron flux, especially that employing fission converter into the irradiation facility and installation of irradiation room were carrying out in the former. In Europe and USA, the accelerator-based BNCT planes are now in progress vigorously, and will have reality. A reform of dynamitron accelerator at University of Birmingham was progressed, and the clinical treatment would be started from September 2000. The accelerator group at MIT has a small type of tandem accelerator, and they were performing basic experiment for BNCS (Boron Neutron Capture Synovectomy) with this accelerator. The concept design for an accelerator and a moderator had been finished at Lawrence Berkeley National Laboratory and University of Berkeley. (author)

  16. Experimental evaluation of boron neutron capture therapy of human breast carcinoma implanted on nude mice

    Science.gov (United States)

    Bose, Satya Ranjan

    2000-06-01

    An in-pool small animal irradiation neutron tube (SAINT) facility was designed, constructed and installed at the University of Virginia Nuclear Research Reactor (UVAR). Thermal neutron flux profiles were measured by foil activation analysis (gold) and verified with DORT and MCNP computer code models. The gamma-ray absorbed dose in the neutron-gamma mixed field was determined from TLD measurements. The SAINT thermal neutron flux was used to investigate the well characterized human breast cancer cell line MCF-7B on both in-vitro samples and in- vivo animal subjects. Boronophenylalanine (BPA enriched in 95% 10B) was used as a neutron capturing agent. The in-vitro response of MCF-7B human breast carcinoma cells to BPA in a mixed field of neutron-gamma radiation or pure 60Co gamma radiation was investigated. The best result (lowest surviving fraction) was observed in cell cultures pre-incubated with BPA and given the neutron irradiation. The least effective treatment consisted of 60Co irradiation only. Immunologically deficient nude mice were inoculated subcutaneously with human breast cancer MCF-7B cells and estradiol pellets (to support tumor growth). The tumor volume in the mouse control group increased over time, as expected. The group of mice exposed only to neutron treatment exhibited initial tumor volume reduction lasting until 35 days following the treatment, followed by renewed tumor growth. Both groups given BPA plus neutron treatment showed continuous reduction in tumor volume over the 55-day observation period. The group given the higher BPA concentration showed the best tumor reduction response. The results on both in-vitro and in-vivo studies showed increased cell killing with BPA, substantiating the incorporation of BPA into the tumor or cell line. Therefore, BNCT may be a possible choice for the treatment of human breast carcinoma. However, prior to the initiation of any clinical studies, it is necessary to determine the therapeutic efficacy in a large

  17. From radiation-induced chromosome damage to cell death: modelling basic mechanisms and applications to boron neutron capture therapy.

    Science.gov (United States)

    Ballarini, F; Bortolussi, S; Clerici, A M; Ferrari, C; Protti, N; Altieri, S

    2011-02-01

    Cell death is a crucial endpoint in radiation-induced biological damage: on one side, cell death is a reference endpoint to characterise the action of radiation in biological targets; on the other side, any cancer therapy aims to kill tumour cells. Starting from Lea's target theory, many models have been proposed to interpret radiation-induced cell killing; after briefly discussing some of these models, in this paper, a mechanistic approach based on an experimentally observed link between chromosome aberrations and cell death was presented. More specifically, a model and a Monte Carlo code originally developed for chromosome aberrations were extended to simulate radiation-induced cell death applying an experimentally observed one-to-one relationship between the average number of 'lethal aberrations' (dicentrics, rings and deletions) per cell and -ln S, S being the fraction of surviving cells. Although such observation was related to X rays, in the present work, the approach was also applied to protons and alpha particles. A good agreement between simulation outcomes and literature data provided a model validation for different radiation types. The same approach was then successfully applied to simulate the survival of cells enriched with boron and irradiated with thermal neutrons at the Triga Mark II reactor in Pavia, to mimic a typical treatment for boron neutron capture therapy.

  18. Feasibility study on the utilization of boron neutron capture therapy (BNCT) in a rat model of diffuse lung metastases

    Energy Technology Data Exchange (ETDEWEB)

    Bakeine, G.J. [Department of Clinical Medicine and Neurology, Cattinara Hospital, University of Trieste (Italy)], E-mail: jamesbakeine1@yahoo.com; Di Salvo, M. [Department of Nuclear and Theoretical Physics, University of Pavia, Via Bassi 6, Pavia (Italy); Bortolussi, S.; Stella, S. [Department of Nuclear and Theoretical Physics, University of Pavia, Via Bassi 6, Pavia (Italy); National Institute of Nuclear Physics (INFN) Section of Pavia, Via Bassi 6, Pavia (Italy); Bruschi, P. [Department of Nuclear and Theoretical Physics, University of Pavia, Via Bassi 6, Pavia (Italy); Bertolotti, A.; Nano, R. [Department of Animal Biology University of Pavia, Piazza Botta, Pavia (Italy); Clerici, A.; Ferrari, C.; Zonta, C. [Department of Surgery University of Pavia, Piazza Botta, Pavia (Italy); Marchetti, A. [Scientific Research Office, Fondazione San Matteo University Policlinic, Pavia (Italy); Altieri, S. [Department of Nuclear and Theoretical Physics, University of Pavia, Via Bassi 6, Pavia (Italy); National Institute of Nuclear Physics (INFN) Section of Pavia, Via Bassi 6, Pavia (Italy)

    2009-07-15

    In order for boron neutron capture therapy (BNCT) to be eligible for application in lung tumour disease, three fundamental criteria must be fulfilled: there must be selective uptake of boron in the tumour cells with respect to surrounding healthy tissue, biological effectiveness of the radiation therapy and minimal damage or collateral effects of the irradiation on the surrounding tissues. In this study, we evaluated the biological effectiveness of BNCT by in vitro irradiation of rat colon-carcinoma cells previously incubated in boron-enriched medium. One part of these cells was re-cultured in vitro while the other was inoculated via the inferior vena cava to induce pulmonary metastases in a rat model. We observed a post-irradiation in vitro cell viability of 0.05% after 8 days of cell culture. At 4 months follow-up, all animal subjects in the treatment group that received irradiated boron-containing cells were alive. No animal survived beyond 1 month in the control group that received non-treated cells (p<0.001 Kaplan-Meier). These preliminary findings strongly suggest that BNCT has a significant lethal effect on tumour cells and post irradiation surviving cells lose their malignant capabilities in vivo. This radio-therapeutic potential warrants the investigation of in vivo BNCT for lung tumour metastases.

  19. Boron neutron capture therapy at the Institute of Medical Radiobiology (IMR) and Paul Scherrer Institute (PSI)

    Science.gov (United States)

    Argentini, M.; Arkuszewski, J.; Crawford, John F.; Larsson, B.; Stepanek, Jiri; Teichmann, Sarah; Weinreich, R.

    1997-02-01

    Although all of the over 200 patients treated with NCT have been irradiated by reactor-produced neutrons, in the present climate of public opinion one cannot expect the routine use of nuclear reactors in hospitals or clinics to be tolerated. While there are several other methods of producing neutrons in the necessary quantities, the Paul Scherrer Institute (PSI) is very well placed to develop techniques base don spallation, in which a beam of protons hits a production target of some convenient material such as tungsten. Because spallation produces neutrons of very similar energies to reactors, the problem of moderating them to keV energies is rather similar. However, there is an additional component of high-energy neutrons, whose intensity depends on the energy of the initial beam, which has to be taken into account in any practical design. Simulations using the well-known codes LAHET, MCNP and GEANT show that a 100 (mu) A beam of 72 MeV protons, well within the capabilities of PSI, could produce enough keV neutrons for therapy.

  20. Relative biological effectiveness and tolerance dose of fission neutrons in canine skin for a potential combination of neutron capture therapy and fast-neutron therapy.

    Science.gov (United States)

    Kadosawa, Tsuyoshi; Ohashi, Fumihito; Nishimura, Ryohei; Sasaki, Nobuo; Saito, Isao; Wakabayashi, Hiroaki; Takeuchi, Akira

    2003-10-01

    To investigate the potential efficacy of fission neutrons from a fast-neutron reactor for the treatment of radioresistant tumors, the relative biological effectiveness (RBE) and tolerance dose of fission neutrons in canine skin were determined. The forelimbs of 34 healthy mongrel dogs received a single dose of fission neutrons (5.6, 6.8, 8.2, 9.6 or 11 Gy) or 137Cs gamma rays (10, 15, 20, 25 or 30 Gy). Based on observations of radiodermatitis for each radiation, the single-fraction RBE of fission neutrons in the sixth month was calculated as approximately 3. The tolerance doses of fission neutrons and gamma rays, defined as the highest doses giving no moist desquamation on the irradiated skin in the recovery phase, were estimated as 7.6 Gy and 20 Gy, respectively. The tolerance dose of 7.6 Gy of fission neutrons included 5.0 Gy of fast neutrons possessing high anti-tumor effects and 1.4 x 10(12) n/cm2 of thermal neutrons, which could be applicable to neutron capture therapy (NCT). The combination of fast-neutron therapy and NCT using a fast-neutron reactor might be useful for the treatment of radioresistant tumors.

  1. Preparation and characterization of Boron carbide nanoparticles for use as a novel agent in T cell-guided boron neutron capture therapy

    DEFF Research Database (Denmark)

    Mortensen, M. W.; Sørensen, P. G.; Björkdahl, O.;

    2006-01-01

    Boron carbide nanoparticles are proposed as a system for T cell-guided boron neutron capture therapy. Nanoparticles were produced by ball milling in various atmospheres of commercially available boron carbide. The physical and chemical properties of the particles were investigated using...

  2. Application of adjoint Monte Carlo to accelerate simulations of mono-directional beams in treatment planning for Boron Neutron Capture Therapy

    NARCIS (Netherlands)

    Nievaart, V.A.; Legrady, D.; Moss, R.L.; Kloosterman, J.L.; Van der Hagen, T.H.; Van Dam, H.

    2007-01-01

    This paper deals with the application of the adjoint transport theory in order to optimize Monte Carlo based radiotherapy treatment planning. The technique is applied to Boron Neutron Capture Therapy where most often mixed beams of neutrons and gammas are involved. In normal forward Monte Carlo simu

  3. Electrostatic design and beam transport for a folded tandem electrostatic quadrupole accelerator facility for accelerator-based boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Thatar Vento, V., E-mail: Vladimir.ThatarVento@gmail.com [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral. Paz 1499 (1650), San Martin, Buenos Aires (Argentina)] [CONICET, Av. Rivadavia 1917 (1033), Ciudad Autonoma de Buenos Aires (Argentina); Bergueiro, J.; Cartelli, D. [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral. Paz 1499 (1650), San Martin, Buenos Aires (Argentina)] [CONICET, Av. Rivadavia 1917 (1033), Ciudad Autonoma de Buenos Aires (Argentina); Valda, A.A. [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral. Paz 1499 (1650), San Martin, Buenos Aires (Argentina)] [Escuela de Ciencia y Tecnologia, UNSAM, M. Irigoyen 3100 (1650), San Martin, Buenos Aires (Argentina); Kreiner, A.J. [Gerencia de Investigacion y Aplicaciones, CNEA, Av. Gral. Paz 1499 (1650), San Martin, Buenos Aires (Argentina)] [CONICET, Av. Rivadavia 1917 (1033), Ciudad Autonoma de Buenos Aires (Argentina)] [Escuela de Ciencia y Tecnologia, UNSAM, M. Irigoyen 3100 (1650), San Martin, Buenos Aires (Argentina)

    2011-12-15

    Within the frame of an ongoing project to develop a folded Tandem-Electrostatic-Quadrupole (TESQ) accelerator facility for Accelerator-Based Boron Neutron Capture Therapy (AB-BNCT), we discuss here the electrostatic design of the machine, including the accelerator tubes with electrostatic quadrupoles and the simulations for the transport and acceleration of a high intensity beam.

  4. Optimization of the geometry and composition of a neutron system for treatment by Boron Neutron Capture Therapy

    Directory of Open Access Journals (Sweden)

    Rohollah Gheisari

    2015-01-01

    Full Text Available Background: In the field of the treatment by Boron Neutron Capture Therapy (BNCT, an optimized neutron system was proposed. This study (simulation was conducted to optimize the geometry and composition of neutron system and increase the epithermal neutron flux for the treatment of deep tumors is performed. Materials and Methods: A neutron system for BNCT was proposed. The system included 252Cf neutron source, neutron moderator/reflector arrangement, filter and concrete. To capture fast neutrons, different neutron filters Fe, Pb, Ni and PbF2 with various thicknesses were simulated and studied. Li (with 1 mm thick was used for filtering of thermal neutrons. Bi with thickness of 1 cm was used to minimize the intensity of gamma rays. Monte Carlo simulation code MCNPX 2.4.0 was used for design of the neutron system and calculation of the neutron components at the output port of the system. Results: For different thicknesses of the filters, the fast neutron flux, the epithermal and thermal flux were calculated at the output port of the system. The spatial distribution of the fast neutron flux, the epithermal flux and gamma flux in human head phantom with the presence of 40 ppm of 10B were obtained. The present calculations showed that Pb filter (about 1 cm at the output port is suitable for fast neutron capture. The thickness of Li filter was determined due to its high absorption cross-section in thermal region. Bi was used as a gamma filter by the reason of it is good for shielding gamma rays, while having high transmission epithermal neutrons. Conclusion: The epithermal neutron flux has enhanced about 38 percent at the output port of the present system, compared with recent system proposed by Ghassoun et al. At 2 cm depth inside the head phantom, the neutron flux reaches a maximum value about . At this depth, the ratio of the thermal neutron flux to the epithermal flux is about three times, that suggests such a neutron system to treat tumors in the

  5. Shielding design and dose assessment for accelerator based neutron capture therapy.

    Science.gov (United States)

    Howard, W B; Yanch, J C

    1995-05-01

    Preparations are ongoing to test the viability and usefulness of an accelerator source of epithermal neutrons for ultimate use in a clinical environment. This feasibility study is to be conducted in a shielded room located on the Massachusetts Institute of Technology campus and will not involve patient irradiations. The accelerator production of neutrons is based on the 7Li(p, n)7Be reaction, and a maximum proton beam current of 4 mA at an energy of 2.5 MeV is anticipated. The resultant 3.58 x 10(12) neutrons s-1 have a maximum energy of 800 keV and will be substantially moderated. This paper describes the Monte Carlo methods used to estimate the neutron and photon dose rates in a variety of locations in the vicinity of the accelerator, as well as the shielding configuration required when the device is run at maximum current. Results indicate that the highest absorbed dose rate to which any individual will be exposed is 3 microSv h-1 (0.3 mrem h-1). The highest possible yearly dose is 0.2 microSv (2 x 10(-2) mrem) to the general public or 0.9 mSv (90 mrem) to a radiation worker in close proximity to the accelerator facility. The shielding necessary to achieve these dose levels is also discussed.

  6. The requirements and development of neutron beams for neutron capture therapy of brain cancer.

    Science.gov (United States)

    Moss, R L; Aizawa, O; Beynon, D; Brugger, R; Constantine, G; Harling, O; Liu, H B; Watkins, P

    1997-05-01

    One of the two overriding conditions for successful BNCT is that there must be a sufficient number of thermal neutrons delivered to each of the boronated cells in the tumour bed (target volume). Despite the poor experience with BNCT in the USA some 40 years ago, the continued apparent success of BNCT in Japan since 1968, lead indirectly to the re-start of clinical trials on BNCT in 1994 at both Brookhaven and MIT. Similar trials will start soon at Petten in Europe. At other centres worldwide, many neutron beam designs are being proposed with either thermal or epithermal neutrons, emanating predominantly from nuclear research reactors. It is apparent that whilst the success of BNCT depends on a suitable neutron beam, there is a diversity in available designs, as well as each proposed type of neutron source, with consequently different characteristics of the emergent neutron beam. The paper presents the historical development of neutron beams used for BNCT, addresses the requirements on the types of beams, describes some of the existing designs and other proposals elsewhere and lastly, considers the broader requirements in designing NCT facilities. The focus of the paper is on treatment of brain cancer, neutron beam requirements for other types of cancer may vary.

  7. Design calculations of an epithermal neutron beam and development of a treatment planning system for the renovation of thor for boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Y-W H.; Teng, Y.H.; Liao, M.Z. [National Tsing Hua Univ., Department of Engineering and System Science, Taiwan (China)

    2000-10-01

    Tsing Hua University was recently granted by National Science Council a five-year project to renovate its Open-Pool reactor (THOR) for boron neutron capture therapy. With this support, the whole graphite blocks in the original thermal column region can be removed for redesigning and constructing a better epithermal neutron beam. THOR is a 1 MW research reactor. The cross section area of the core facing the thermal column is 60 cm x 50 cm. By using 60 cm FLUENTAL plus 10 cm Pb, with cross section area of 70 cm x 60 cm and surrounded by 6 cm thick PbF{sub 2} reflector, the epithermal neutron flux at the filter/moderator exit can reach {approx}8.5 x 10{sup 9} n/cm{sup 2}/s. When the collimator is added, the epithermal neutron beam intensity at the beam exit is reduced to 3 x 10{sup 9} n/cm{sup 2}/sec, but is still six times higher than the previous beam. Facing the clinical trials scheduled 3 and half years from now, a preliminary version of treatment planning system is developed. It includes a pre-processor to read CT scan and post-processors to display dose distributions. (author)

  8. Monte Carlo methods of neutron beam design for neutron capture therapy at the MIT Research Reactor (MITR-II).

    Science.gov (United States)

    Clement, S D; Choi, J R; Zamenhof, R G; Yanch, J C; Harling, O K

    1990-01-01

    Monte Carlo methods of coupled neutron/photon transport are being used in the design of filtered beams for Neutron Capture Therapy (NCT). This method of beam analysis provides segregation of each individual dose component, and thereby facilitates beam optimization. The Monte Carlo method is discussed in some detail in relation to NCT epithermal beam design. Ideal neutron beams (i.e., plane-wave monoenergetic neutron beams with no primary gamma-ray contamination) have been modeled both for comparison and to establish target conditions for a practical NCT epithermal beam design. Detailed models of the 5 MWt Massachusetts Institute of Technology Research Reactor (MITR-II) together with a polyethylene head phantom have been used to characterize approximately 100 beam filter and moderator configurations. Using the Monte Carlo methodology of beam design and benchmarking/calibrating our computations with measurements, has resulted in an epithermal beam design which is useful for therapy of deep-seated brain tumors. This beam is predicted to be capable of delivering a dose of 2000 RBE-cGy (cJ/kg) to a therapeutic advantage depth of 5.7 cm in polyethylene assuming 30 micrograms/g 10B in tumor with a ten-to-one tumor-to-blood ratio, and a beam diameter of 18.4 cm. The advantage ratio (AR) is predicted to be 2.2 with a total irradiation time of approximately 80 minutes. Further optimization work on the MITR-II epithermal beams is expected to improve the available beams.

  9. Designing an epithermal neutron beam for boron neutron capture therapy for a DIDO type reactor using MCNP

    Science.gov (United States)

    Ross, D.; Constantine, G.; Weaver, D. R.; Beynon, T. D.

    1993-10-01

    This paper describes work undertaken to design an epithermal neutron beam for a DIDO type reactor for use in boron neutron capture therapy, a form of cancer treatment. It involved extensive use of MCNP, a Monte Carlo computer code. Initially, calculations were made with MCNP to simulate earlier experiments with an epithermal beam on the DIDO reactor. This comparison made it possible both to validate the Monte Carlo modelling of the reactor and to gain an insight into the important features of the simulation. Following this, MCNP was used to design a filtered epithermal neutron beam facility for DIDO's largest beam tube, a 13.7 cm radius horizontal tube which extends radially away from the core. First a selection was made of the optimum filter components for the beam. Then the research concentrated on combining these filter elements to construct a practical epithermal beam design. The results suggest that the optimum method of generating the epithermal neutron source is to employ a filter combination consisting principally of liquid argon with the addition of cadmium, aluminium, titanium and possibly tin. The calculations also show that the resultant neutron beam would have a flux greater than 1.0 × 10 9 n cm -2 s -1 and have sufficiently low fast-neutron and gamma-ray contamination.

  10. Experimental verification of improved depth-dose distribution using hyper-thermal neutron incidence in neutron capture therapy

    Science.gov (United States)

    Sakurai, Yoshinori; Kobayashi, Tooru

    2001-01-01

    We have proposed the utilization of `hyper-thermal neutrons' for neutron capture therapy (NCT) from the viewpoint of the improvement in the dose distribution in a human body. In order to verify the improved depth-dose distribution due to hyper-thermal neutron incidence, two experiments were carried out using a test-type hyper-thermal neutron generator at a thermal neutron irradiation field in Kyoto University Reactor (KUR), which is actually utilized for NCT clinical irradiation. From the free-in-air experiment for the spectrum-shift characteristics, it was confirmed that the hyper-thermal neutrons of approximately 860 K at maximum could be obtained by the generator. From the phantom experiment, the improvement effect and the controllability for the depth-dose distribution were confirmed. For example, it was found that the relative neutron depth-dose distribution was about 1 cm improved with the 860 K hyper-thermal neutron incidence, compared to the normal thermal neutron incidence.

  11. Synthesis, characterization and biological evaluation of carboranylmethylbenzo[b]acridones as novel agents for boron neutron capture therapy.

    Science.gov (United States)

    da Silva, A Filipa F; Seixas, Raquel S G R; Silva, Artur M S; Coimbra, Joana; Fernandes, Ana C; Santos, Joana P; Matos, António; Rino, José; Santos, Isabel; Marques, Fernanda

    2014-07-28

    Herein we present the synthesis and characterization of benzo[b]acridin-12(7H)-ones bearing carboranyl moieties and test their biological effectiveness as boron neutron capture therapy (BNCT) agents in cancer treatment. The cellular uptake of these novel compounds into the U87 human glioblastoma cells was evaluated by boron analysis (ICP-MS) and by fluorescence imaging (confocal microscopy). The compounds enter the U87 cells exhibiting a similar profile, i.e., preferential accumulation in the cytoskeleton and membranes and a low cytotoxic activity (IC50 values higher than 200 μM). The cytotoxic activity and cellular morphological alterations after neutron irradiation in the Portuguese Research Reactor (6.6 × 10(7) neutrons cm(-2) s(-1), 1 MW) were evaluated by the MTT assay and by electron microscopy (TEM). Post-neutron irradiation revealed that BNCT has a higher cytotoxic effect on the cells. Accumulation of membranous whorls in the cytoplasm of cells treated with one of the compounds correlates well with the cytotoxic effect induced by radiation. Results provide a strong rationale for considering one of these compounds as a lead candidate for a new generation of BNCT agents.

  12. In-phantom two-dimensional thermal neutron distribution for intraoperative boron neutron capture therapy of brain tumours

    Science.gov (United States)

    Yamamoto, T.; Matsumura, A.; Yamamoto, K.; Kumada, H.; Shibata, Y.; Nose, T.

    2002-07-01

    The aim of this study was to determine the in-phantom thermal neutron distribution derived from neutron beams for intraoperative boron neutron capture therapy (IOBNCT). Gold activation wires arranged in a cylindrical water phantom with (void-in-phantom) or without (standard phantom) a cylinder styrene form placed inside were irradiated by using the epithermal beam (ENB) and the mixed thermal-epithermal beam (TNB-1) at the Japan Research Reactor No 4. With ENB, we observed a flattened distribution of thermal neutron flux and a significantly enhanced thermal flux delivery at a depth compared with the results of using TNB-1. The thermal neutron distribution derived from both the ENB and TNB-1 was significantly improved in the void-in-phantom, and a double high dose area was formed lateral to the void. The flattened distribution in the circumference of the void was observed with the combination of ENB and the void-in-phantom. The measurement data suggest that the ENB may provide a clinical advantage in the form of an enhanced and flattened dose delivery to the marginal tissue of a post-operative cavity in which a residual and/or microscopically infiltrating tumour often occurs. The combination of the epithermal neutron beam and IOBNCT will improve the clinical results of BNCT for brain tumours.

  13. Spectrum evaluation at the filter-modified neutron irradiation field for neutron capture therapy in Kyoto University Research Reactor

    Science.gov (United States)

    Sakurai, Yoshinori; Kobayashi, Tooru

    2004-10-01

    The Heavy Water Neutron Irradiation Facility of the Kyoto University Research Reactor (KUR-HWNIF) was updated in March 1996, mainly to improve the facility for neutron capture therapy (NCT). In this facility, neutron beams with various energy spectra, from almost pure thermal to epithermal, are available. The evaluation of the neutron energy spectra by multi-activation-foil method was performed as a series of the facility characterization. The spectra at the normal irradiation position were evaluated for the combinations of heavy-water thickness of the spectrum shifter and the open-close condition of the cadmium and boral filters. The initial spectra were made mainly using a two-dimensional transport code, and the final spectra were obtained using an adjusting code. For the verification of the evaluated spectra, simulation calculations using a phantom were performed on the assumption of NCT-clinical-irradiation conditions. It resulted that the calculated data for the depth neutron-flux distributions were in good agreement with the experimental ones.

  14. Boron neutron capture therapy design calculation of a 3H(p,n reaction based BSA for brain cancer setup

    Directory of Open Access Journals (Sweden)

    Bassem Elshahat

    2015-09-01

    Full Text Available Purpose: Boron neutron capture therapy (BNCT is a promising technique for the treatment of malignant disease targeting organs of the human body. Monte Carlo simulations were carried out to calculate optimum design parameters of an accelerator based beam shaping assembly (BSA for BNCT of brain cancer setup.Methods: Epithermal beam of neutrons were obtained through moderation of fast neutrons from 3H(p,n reaction in a high density polyethylene moderator and a graphite reflector. The dimensions of the moderator and the reflector were optimized through optimization of epithermal / fast neutron intensity ratio as a function of geometric parameters of the setup. Results: The results of our calculation showed the capability of our setup to treat the tumor within 4 cm of the head surface. The calculated peak therapeutic ratio for the setup was found to be 2.15. Conclusion: With further improvement in the polyethylene moderator design and brain phantom irradiation arrangement, the setup capabilities can be improved to reach further deep-seated tumor.

  15. Experimental verification of improved depth-dose distribution using hyper-thermal neutron incidence in neutron capture therapy.

    Science.gov (United States)

    Sakurai, Y; Kobayashi, T

    2001-01-01

    We have proposed the utilization of 'hyper-thermal neutrons' for neutron capture therapy (NCT) from the viewpoint of the improvement in the dose distribution in a human body. In order to verify the improved depth-dose distribution due to hyper-thermal neutron incidence, two experiments were carried out using a test-type hyper-thermal neutron generator at a thermal neutron irradiation field in Kyoto University Reactor (KUR), which is actually utilized for NCT clinical irradiation. From the free-in-air experiment for the spectrum-shift characteristics, it was confirmed that the hyper-thermal neutrons of approximately 860 K at maximum could be obtained by the generator. From the phantom experiment, the improvement effect and the controllability for the depth-dose distribution were confirmed. For example, it was found that the relative neutron depth-dose distribution was about 1 cm improved with the 860 K hyper-thermal neutron incidence, compared to the normal thermal neutron incidence.

  16. User's manual of a supporting system for treatment planning in boron neutron capture therapy. JAERI computational dosimetry system

    CERN Document Server

    Kumada, H

    2002-01-01

    A boron neutron capture therapy (BNCT) with epithermal neutron beam is expected to treat effectively for malignant tumor that is located deeply in the brain. It is indispensable to estimate preliminarily the irradiation dose in the brain of a patient in order to perform the epithermal neutron beam BNCT. Thus, the JAERI Computational Dosimetry System (JCDS), which can calculate the dose distributions in the brain, has been developed. JCDS is a software that creates a 3-dimensional head model of a patient by using CT and MRI images and that generates a input data file automatically for calculation neutron flux and gamma-ray dose distribution in the brain by the Monte Carlo code: MCNP, and that displays the dose distribution on the head model for dosimetry by using the MCNP calculation results. JCDS has any advantages as follows; By treating CT data and MRI data which are medical images, a detail three-dimensional model of patient's head is able to be made easily. The three-dimensional head image is editable to ...

  17. Two Years versus One Year of Tianjiu Therapy in Sanfu Days for Chronic Asthma: A Clinical Efficacy Observation Trial

    Directory of Open Access Journals (Sweden)

    Li Bing Zhu

    2014-01-01

    Full Text Available Background. Tianjiu therapy has established efficacy against chronic asthma with related symptoms or the medication need during asthma attack. This study aimed to explore the optimal duration of Tianjiu therapy for asthma. Methods. This study was a self-comparison-to-the-baseline study, which comparing treatment with Tianjiu therapy for 1 year and 2 years in the same 102 chronic asthma patients. Totally 6 sessions of Tianjiu treatment were provided, 3 sessions in a year as a course of treatment and totally two years treatment. The primary endpoint was the number of asthma related symptoms which frequently appeared in asthma patients and the frequency of bronchodilator used during asthma attack. Results. The frequency of bronchodilator used during asthma attack significantly improved (χ2=46.276, P=0.000. But the number of asthma related symptoms which frequently appeared in asthma patients added by 1.38 points (95% CI, 0.25 to 2.51, 2.93±0.41 in 1-year group and 4.31±0.41 in the 2-years group (P<0.05. Conclusions. The effect of 2 years Tianjiu therapy was not as effective as 1 year such treatment for asthma, but the second year Tianjiu therapy was still needed because it has a role to consolidate the curative effect of Tianjiu therapy for asthma.

  18. Capture and Transport of Laser Accelerated Protons by Pulsed Magnetic Fields: Advancements Toward Laser-Based Proton Therapy

    Science.gov (United States)

    Burris-Mog, Trevor J.

    The interaction of intense laser light (I > 10 18 W/cm2) with a thin target foil leads to the Target Normal Sheath Acceleration mechanism (TNSA). TNSA is responsible for the generation of high current, ultra-low emittance proton beams, which may allow for the development of a compact and cost effective proton therapy system for the treatment of cancer. Before this application can be realized, control is needed over the large divergence and the 100% kinetic energy spread that are characteristic of TNSA proton beams. The work presented here demonstrates control over the divergence and energy spread using strong magnetic fields generated by a pulse power solenoid. The solenoidal field results in a parallel proton beam with a kinetic energy spread DeltaE/E = 10%. Assuming that next generation lasers will be able to operate at 10 Hz, the 10% spread in the kinetic energy along with the 23% capture efficiency of the solenoid yield enough protons per laser pulse to, for the first time, consider applications in Radiation Oncology. Current lasers can generate proton beams with kinetic energies up to 67.5 MeV, but for therapy applications, the proton kinetic energy must reach 250 MeV. Since the maximum kinetic energy Emax of the proton scales with laser light intensity as Emax ∝ I0.5, next generation lasers may very well accelerate 250 MeV protons. As the kinetic energy of the protons is increased, the magnetic field strength of the solenoid will need to increase. The scaling of the magnetic field B with the kinetic energy of the protons follows B ∝ E1/2. Therefor, the field strength of the solenoid presented in this work will need to be increased by a factor of 2.4 in order to accommodate 250 MeV protons. This scaling factor seems reasonable, even with present technology. This work not only demonstrates control over beam divergence and energy spread, it also allows for us to now perform feasibility studies to further research what a laser-based proton therapy system

  19. Current status of boron neutron capture therapy of high grade gliomas and recurrent head and neck cancer

    Science.gov (United States)

    2012-01-01

    Boron neutron capture therapy (BNCT) is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Clinical interest in BNCT has focused primarily on the treatment of high grade gliomas, recurrent cancers of the head and neck region and either primary or metastatic melanoma. Neutron sources for BNCT currently have been limited to specially modified nuclear reactors, which are or until the recent Japanese natural disaster, were available in Japan, the United States, Finland and several other European countries, Argentina and Taiwan. Accelerators producing epithermal neutron beams also could be used for BNCT and these are being developed in several countries. It is anticipated that the first Japanese accelerator will be available for therapeutic use in 2013. The major hurdle for the design and synthesis of boron delivery agents has been the requirement for selective tumor targeting to achieve boron concentrations in the range of 20 μg/g. This would be sufficient to deliver therapeutic doses of radiation with minimal normal tissue toxicity. Two boron drugs have been used clinically, a dihydroxyboryl derivative of phenylalanine, referred to as boronophenylalanine or “BPA”, and sodium borocaptate or “BSH” (Na2B12H11SH). In this report we will provide an overview of other boron delivery agents that currently are under evaluation, neutron sources in use or under development for BNCT, clinical dosimetry, treatment planning, and finally a summary of previous and on-going clinical studies for high grade gliomas and recurrent tumors of the head and neck region. Promising results have been obtained with both groups of patients but these outcomes must be more rigorously evaluated in larger, possibly randomized

  20. Current status of boron neutron capture therapy of high grade gliomas and recurrent head and neck cancer.

    Science.gov (United States)

    Barth, Rolf F; Vicente, M Graca H; Harling, Otto K; Kiger, W S; Riley, Kent J; Binns, Peter J; Wagner, Franz M; Suzuki, Minoru; Aihara, Teruhito; Kato, Itsuro; Kawabata, Shinji

    2012-08-29

    Boron neutron capture therapy (BNCT) is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Clinical interest in BNCT has focused primarily on the treatment of high grade gliomas, recurrent cancers of the head and neck region and either primary or metastatic melanoma. Neutron sources for BNCT currently have been limited to specially modified nuclear reactors, which are or until the recent Japanese natural disaster, were available in Japan, United States, Finland and several other European countries, Argentina and Taiwan. Accelerators producing epithermal neutron beams also could be used for BNCT and these are being developed in several countries. It is anticipated that the first Japanese accelerator will be available for therapeutic use in 2013. The major hurdle for the design and synthesis of boron delivery agents has been the requirement for selective tumor targeting to achieve boron concentrations in the range of 20 μg/g. This would be sufficient to deliver therapeutic doses of radiation with minimal normal tissue toxicity. Two boron drugs have been used clinically, a dihydroxyboryl derivative of phenylalanine, referred to as boronophenylalanine or "BPA", and sodium borocaptate or "BSH" (Na2B12H11SH). In this report we will provide an overview of other boron delivery agents that currently are under evaluation, neutron sources in use or under development for BNCT, clinical dosimetry, treatment planning, and finally a summary of previous and on-going clinical studies for high grade gliomas and recurrent tumors of the head and neck region. Promising results have been obtained with both groups of patients but these outcomes must be more rigorously evaluated in larger, possibly randomized clinical trials

  1. Current status of boron neutron capture therapy of high grade gliomas and recurrent head and neck cancer

    Directory of Open Access Journals (Sweden)

    Barth Rolf F

    2012-08-01

    Full Text Available Abstract Boron neutron capture therapy (BNCT is a biochemically targeted radiotherapy based on the nuclear capture and fission reactions that occur when non-radioactive boron-10, which is a constituent of natural elemental boron, is irradiated with low energy thermal neutrons to yield high linear energy transfer alpha particles and recoiling lithium-7 nuclei. Clinical interest in BNCT has focused primarily on the treatment of high grade gliomas, recurrent cancers of the head and neck region and either primary or metastatic melanoma. Neutron sources for BNCT currently have been limited to specially modified nuclear reactors, which are or until the recent Japanese natural disaster, were available in Japan, United States, Finland and several other European countries, Argentina and Taiwan. Accelerators producing epithermal neutron beams also could be used for BNCT and these are being developed in several countries. It is anticipated that the first Japanese accelerator will be available for therapeutic use in 2013. The major hurdle for the design and synthesis of boron delivery agents has been the requirement for selective tumor targeting to achieve boron concentrations in the range of 20 μg/g. This would be sufficient to deliver therapeutic doses of radiation with minimal normal tissue toxicity. Two boron drugs have been used clinically, a dihydroxyboryl derivative of phenylalanine, referred to as boronophenylalanine or “BPA”, and sodium borocaptate or “BSH” (Na2B12H11SH. In this report we will provide an overview of other boron delivery agents that currently are under evaluation, neutron sources in use or under development for BNCT, clinical dosimetry, treatment planning, and finally a summary of previous and on-going clinical studies for high grade gliomas and recurrent tumors of the head and neck region. Promising results have been obtained with both groups of patients but these outcomes must be more rigorously evaluated in larger

  2. Preclinical studies of neutron capture therapy effectiveness in the treatment of malignant tumours, at the nuclear reactor hvr-sm InP as of RUz Preclinical studies of neutron capture therapy effectiveness in the treatment of malignant tumours, at the nuclear reactor hvr-sm InP as of RUz

    OpenAIRE

    KHODJAEVA NAZIMA KHAYRULLAEVNA; NAVRUZOV SARIMBEK NAVRUZOVICH; KAHHOROV JAMAL NEMATOVICH; KULABDULLAEV GAYRAT ASATOVICH; КIM ANDREY ALEKSEEVICH

    2016-01-01

    Developed for treatment of radio resistant malignant tumors the Gadolinium neutron capture therapy (GdNCT) is based on the nuclear capture and reactions that occur when 155Gd and 157Gd, which are non-radioactive constituents of natural elemental gadolinium, are irradiated by thermal neutrons with low energy, In this article, results of scientific researches on development GdNCT in Uzbekistan are presented. The beam of epithermal neutrons with characteristics satisfying the all requirements of...

  3. Measurements of neutron distribution in neutrons-gamma-rays mixed field using imaging plate for neutron capture therapy.

    Science.gov (United States)

    Tanaka, Kenichi; Endo, Satoru; Hoshi, Masaharu

    2010-01-01

    The imaging plate (IP) technique is tried to be used as a handy method to measure the spatial neutron distribution via the (157)Gd(n,gamma)(158)Gd reaction for neutron capture therapy (NCT). For this purpose, IP is set in a water phantom and irradiated in a mixed field of neutrons and gamma-rays. The Hiroshima University Radiobiological Research Accelerator is utilized for this experiment. The neutrons are moderated with 20-cm-thick D(2)O to obtain suitable neutron field for NCT. The signal for IP doped with Gd as a neutron-response enhancer is subtracted with its contribution by gamma-rays, which was estimated using IP without Gd. The gamma-ray response of Gd-doped IP to non-Gd IP is set at 1.34, the value measured for (60)Co gamma-rays, in estimating the gamma-ray contribution to Gd-doped IP signal. Then measured distribution of the (157)Gd(n,gamma)(158)Gd reaction rate agrees within 10% with the calculated value based on the method that has already been validated for its reproducibility of Au activation. However, the evaluated distribution of the (157)Gd(n,gamma)(158)Gd reaction rate is so sensitive to gamma-ray energy, e.g. the discrepancy of the (157)Gd(n,gamma)(158)Gd reaction rate between measurement and calculation becomes 30% for the photon energy change from 33keV to 1.253MeV.

  4. Boron neutron capture therapy (BNCT) for the treatment of spontaneous nasal planum squamous cell carcinoma in felines.

    Science.gov (United States)

    Trivillin, Verónica A; Heber, Elisa M; Rao, Monica; Cantarelli, María A; Itoiz, Maria E; Nigg, David W; Calzetta, Osvaldo; Blaumann, Herman; Longhino, Juan; Schwint, Amanda E

    2008-02-01

    Recently, Boron neutron capture therapy (BNCT) was successfully applied to treat experimental squamous cell carcinomas (SCC) of the hamster cheek pouch mucosa, with no damage to normal tissue. It was also shown that treating spontaneous nasal planum SCC in terminal feline patients with low dose BNCT is safe and feasible. In an extension of this work, the present study aimed at evaluation of the response of tumor and dose-limiting normal tissues to potentially therapeutic BNCT doses. Biodistribution studies with (10)B-boronophenylalanine (BPA enriched in (10)B) as a (10)B carrier were performed on three felines that showed advanced nasal planum SCC without any standard therapeutic option. Following the biodistribution studies, BNCT mediated by (10)BPA was done using the thermalized epithermal neutron beam at the RA-6 Nuclear Reactor. Follow-up included clinical evaluation, assessment of macroscopic tumor and normal tissue response and biopsies for histopathological analysis. The treated animals did not show any apparent radiation-induced toxicity. All three animals exhibited partial tumor control and an improvement in clinical condition. Enhanced therapeutic efficacy was associated with a high (10)B content of the tumor and a small tumor size. BNCT is therefore believed to be potentially effective in the treatment of spontaneous SCC. However, improvement in targeting (10)B into all tumor cells and delivering a sufficient dose at a greater depth are still required for the treatment of deep-seated, large tumors. Future studies are needed to evaluate the potential efficacy of the dual mode cellular (e.g. BPA-BNCT) and vascular (e.g. GB-10-BNCT) targeting protocol in a preclinical scenario, employing combinations of (10)B compounds with different properties and complementary uptake mechanisms.

  5. Characteristics comparison between a cyclotron-based neutron source and KUR-HWNIF for boron neutron capture therapy

    Science.gov (United States)

    Tanaka, H.; Sakurai, Y.; Suzuki, M.; Masunaga, S.; Kinashi, Y.; Kashino, G.; Liu, Y.; Mitsumoto, T.; Yajima, S.; Tsutsui, H.; Maruhashi, A.; Ono, K.

    2009-06-01

    At Kyoto University Research Reactor Institute (KURRI), 275 clinical trials of boron neutron capture therapy (BNCT) have been performed as of March 2006, and the effectiveness of BNCT has been revealed. In order to further develop BNCT, it is desirable to supply accelerator-based epithermal-neutron sources that can be installed near the hospital. We proposed the method of filtering and moderating fast neutrons, which are emitted from the reaction between a beryllium target and 30-MeV protons accelerated by a cyclotron accelerator, using an optimum moderator system composed of iron, lead, aluminum and calcium fluoride. At present, an epithermal-neutron source is under construction from June 2008. This system consists of a cyclotron accelerator, beam transport system, neutron-yielding target, filter, moderator and irradiation bed. In this article, an overview of this system and the properties of the treatment neutron beam optimized by the MCNPX Monte Carlo neutron transport code are presented. The distribution of biological effect weighted dose in a head phantom compared with that of Kyoto University Research Reactor (KUR) is shown. It is confirmed that for the accelerator, the biological effect weighted dose for a deeply situated tumor in the phantom is 18% larger than that for KUR, when the limit dose of the normal brain is 10 Gy-eq. The therapeutic time of the cyclotron-based neutron sources are nearly one-quarter of that of KUR. The cyclotron-based epithermal-neutron source is a promising alternative to reactor-based neutron sources for treatments by BNCT.

  6. Role of p53 mutation in the effect of boron neutron capture therapy on oral squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Ohnishi Ken

    2009-12-01

    Full Text Available Abstract Background Boron neutron capture therapy (BNCT is a selective radiotherapy, being effective for the treatment of even advanced malignancies in head and neck regions as well as brain tumors and skin melanomas. To clarify the role of p53 gene, the effect of BNCT on oral squamous cell carcinoma (SCC cells showing either wild- (SAS/neo or mutant-type (SAS/mp53 p53 was examined. Methods Cells were exposed to neutron beams in the presence of boronophenylalanine (BPA at Kyoto University Research Reactor. Treated cells were monitored for modulations in colony formation, proliferation, cell cycle, and expression of cell cycle-associated proteins. Results When SAS/neo and SAS/mp53 cells were subjected to BNCT, more suppressive effects on colony formation and cell viability were observed in SAS/neo compared with SAS/mp53 cells. Cell cycle arrest at the G1 checkpoint was observed in SAS/neo, but not in SAS/mp53. Apoptotic cells increased from 6 h after BNCT in SAS/neo and 48 h in SAS/mp53 cells. The expression of p21 was induced in SAS/neo only, but G2 arrest-associated proteins including Wee1, cdc2, and cyclin B1 were altered in both cell lines. Conclusion These results indicate that oral SCC cells with mutant-type are more resistant to BNCT than those with wild-type p53, and that the lack of G1 arrest and related apoptosis may contribute to the resistance. At a physical dose affecting the cell cycle, BNCT inhibits oral SCC cells in p53-dependent and -independent manners.

  7. NOTE: Computational study of the required dimensions for standard sized phantoms in boron neutron capture therapy dosimetry

    Science.gov (United States)

    Koivunoro, H.; Auterinen, I.; Kosunen, A.; Kotiluoto, P.; Seppälä, T.; Savolainen, S.

    2003-11-01

    The minimum size of a water phantom used for calibration of an epithermal neutron beam of the boron neutron capture therapy (BNCT) facility at the VTT FiR 1 research reactor is studied by Monte Carlo simulations. The criteria for the size of the phantom were established relative to the neutron and photon radiation fields present at the thermal neutron fluence maximum in the central beam axis (considered as the reference point). At the reference point, for the most commonly used beam aperture size at FiR 1 (14 cm diameter), less than 1% disturbance of the neutron and gamma radiation fields in a phantom were achieved with a minimum a 30 cm × 30 cm cross section of the phantom. For the largest 20 cm diameter beam aperture size, a minimum 40 cm × 40 cm cross-section of the phantom and depth of 20 cm was required to achieve undisturbed radiation field. This size can be considered as the minimum requirement for a reference phantom for dosimetry at FiR 1. The secondary objective was to determine the phantom dimensions for full characterization of the FiR 1 beam in a rectangular water phantom. In the water scanning phantom, isodoses down to the 5% level are measured for the verifications of the beam model in the dosimetric and treatment planning calculations. The dose distribution results without effects caused by the limited phantom size were achieved for the maximum aperture diameter (20 cm) with a 56 cm × 56 cm × 28 cm rectangular phantom. A similar approach to study the required minimum dimensions of the reference and water scanning phantoms can be used for epithermal neutron beams at the other BNCT facilities.

  8. Boron Neutron Capture Therapy (BCNT) for the Treatment of Liver Metastases: Biodistribution Studies of Boron Compounds in an Experimental Model

    Energy Technology Data Exchange (ETDEWEB)

    Marcela A. Garabalino; Andrea Monti Hughes; Ana J. Molinari; Elisa M. Heber; Emiliano C. C. Pozzi; Maria E. Itoiz; Veronica A. Trivillin; Amanda E. Schwint; Jorge E. Cardoso; Lucas L. Colombo; Susana Nievas; David W. Nigg; Romina F. Aromando

    2011-03-01

    Abstract We previously demonstrated the therapeutic efficacy of different boron neutron capture therapy (BNCT) protocols in an experimental model of oral cancer. BNCT is based on the selective accumulation of 10B carriers in a tumor followed by neutron irradiation. Within the context of exploring the potential therapeutic efficacy of BNCT for the treatment of liver metastases, the aim of the present study was to perform boron biodistribution studies in an experimental model of liver metastases in rats. Different boron compounds and administration conditions were assayed to determine which administration protocols would potentially be therapeutically useful in in vivo BNCT studies at the RA-3 nuclear reactor. A total of 70 BDIX rats were inoculated in the liver with syngeneic colon cancer cells DHD/K12/TRb to induce the development of subcapsular tumor nodules. Fourteen days post-inoculation, the animals were used for biodistribution studies. We evaluated a total of 11 administration protocols for the boron compounds boronophenylalanine (BPA) and GB-10 (Na210B10H10), alone or combined at different dose levels and employing different administration routes. Tumor, normal tissue, and blood samples were processed for boron measurement by atomic emission spectroscopy. Six protocols proved potentially useful for BNCT studies in terms of absolute boron concentration in tumor and preferential uptake of boron by tumor tissue. Boron concentration values in tumor and normal tissues in the liver metastases model show it would be feasible to reach therapeutic BNCT doses in tumor without exceeding radiotolerance in normal tissue at the thermal neutron facility at RA-3.

  9. Boronophenylalanine, a boron delivery agent for boron neutron capture therapy, is transported by ATB0,+, LAT1 and LAT2.

    Science.gov (United States)

    Wongthai, Printip; Hagiwara, Kohei; Miyoshi, Yurika; Wiriyasermkul, Pattama; Wei, Ling; Ohgaki, Ryuichi; Kato, Itsuro; Hamase, Kenji; Nagamori, Shushi; Kanai, Yoshikatsu

    2015-03-01

    The efficacy of boron neutron capture therapy relies on the selective delivery of boron carriers to malignant cells. p-Boronophenylalanine (BPA), a boron delivery agent, has been proposed to be localized to cells through transporter-mediated mechanisms. In this study, we screened aromatic amino acid transporters to identify BPA transporters. Human aromatic amino acid transporters were functionally expressed in Xenopus oocytes and examined for BPA uptake and kinetic parameters. The roles of the transporters in BPA uptake were characterized in cancer cell lines. For the quantitative assessment of BPA uptake, HPLC was used throughout the study. Among aromatic amino acid transporters, ATB(0,+), LAT1 and LAT2 were found to transport BPA with Km values of 137.4 ± 11.7, 20.3 ± 0.8 and 88.3 ± 5.6 μM, respectively. Uptake experiments in cancer cell lines revealed that the LAT1 protein amount was the major determinant of BPA uptake at 100 μM, whereas the contribution of ATB(0,+) became significant at 1000 μM, accounting for 20-25% of the total BPA uptake in MCF-7 breast cancer cells. ATB(0,+), LAT1 and LAT2 transport BPA at affinities comparable with their endogenous substrates, suggesting that they could mediate effective BPA uptake in vivo. The high and low affinities of LAT1 and ATB(0,+), respectively, differentiate their roles in BPA uptake. ATB(0,+), as well as LAT1, could contribute significantly to the tumor accumulation of BPA at clinical dose.

  10. Midazolam as an adjunctive therapy for capture myopathy in Bar-tailed Godwits (Limosa lapponica baueri) with prognostic indicators

    NARCIS (Netherlands)

    Ward, Janelle M.; Gartrell, Brett D.; Conklin, Jesse R.; Battley, Phil F.

    2011-01-01

    Capture myopathy is a complication of capture and handling in many species of birds and mammals. Muscular necrosis leads to ataxia, paralysis, and pain, whereas metabolic disturbances can result in death. We conducted an opportunistic clinical trial on Bar-tailed Godwits (Limosa lapponica baueri) th

  11. Cell therapy for heart disease after 15 years: Unmet expectations.

    Science.gov (United States)

    Nigro, Patrizia; Bassetti, Beatrice; Cavallotti, Laura; Catto, Valentina; Carbucicchio, Corrado; Pompilio, Giulio

    2017-02-21

    Over the past two decades cardiac cell therapy (CCT) has emerged as a promising new strategy to cure heart diseases at high unmet need. Thousands of patients have entered clinical trials for acute or chronic heart conditions testing different cell types, including autologous or allogeneic bone marrow (BM)-derived mononuclear or selected cells, BM- or adipose tissue-derived mesenchymal cells, or cardiac resident progenitors based on their potential ability to regenerate scarred or dysfunctional myocardium. Nowadays, the original enthusiasm surrounding the regenerative medicine field has been cushioned by a cumulative body of evidence indicating an inefficient or modest efficacy of CCT in improving cardiac function, along with the continued lack of indisputable proof for long-term prognostic benefit. In this review, we have firstly comprehensively outlined the positive and negative results of cell therapy studies in patients with acute myocardial infarction, refractory angina and chronic heart failure. Next, we have discussed cell therapy- and patient-related variables (e.g. cell intrinsic and extrinsic characteristics as well as criteria of patient selection and proposed methodologies) that might have dampened the efficacy of past cell therapy trials. Finally, we have addressed critical factors to be considered before embarking on further clinical trials.

  12. Boron neutron capture therapy for glioblastoma multiforme using p-boronophenylalanine and epithermal neutrons: trial design and early clinical results.

    Science.gov (United States)

    Coderre, J A; Elowitz, E H; Chadha, M; Bergland, R; Capala, J; Joel, D D; Liu, H B; Slatkin, D N; Chanana, A D

    1997-05-01

    A Phase I/II clinical trial of boron neutron capture therapy (BNCT) for glioblastoma multiforme is underway using the amino acid analog p-boronophenylalanine (BPA) and the epithermal neutron beam at the Brook-haven Medical Research Reactor. Biodistribution studies were carried out in 18 patients at the time of craniotomy using an i.v. infusion of BPA, solubilized as a fructose complex (BPA-F). There were no toxic effects related to the BPA-F administration at doses of 130, 170, 210, or 250 mg BPA/kg body weight. The tumor/ blood, brain/blood and scalp/blood boron concentration ratios were approximately 3.5:1, 1:1 and 1.5:1, respectively. Ten patients have received BNCT following 2-hr infusions of 250 mg BPA/kg body weight. The average boron concentration in the blood during the irradiation was 13.0 +/- 1.5 micrograms 10B/g. The prescribed maximum dose to normal brain (1 cm3 volume) was 10.5 photon-equivalent Gy (Gy-Eq). Estimated maximum and minimum doses (mean +/- sd, n = 10) to the tumor volume were 52.6 +/- 4.9 Gy-Eq (range: 64.4-47.6) and 25.2 +/- 4.2 Gy-Eq (range: 32.3-20.0), respectively). The estimated minimum dose to the target volume (tumor +2 cm margin) was 12.3 +/- 2.7 Gy-Eq (range: 16.2-7.8). There were no adverse effects on normal brain. The scalp showed mild erythema, followed by epilation in the 8 cm diameter field. Four patients developed recurrent tumor, apparently in the lower dose (deeper) regions of the target volume, at post-BNCT intervals of 7,5,3.5 and 3 months, respectively. The remaining patients have had less than 4 months of post-BNCT follow-up. BNCT, at this starting dose level, appears safe. Plans are underway to begin the dose escalation phase of this protocol.

  13. Radiation injury of boron neutron capture therapy using mixed epithermal- and thermal neutron beams in patients with malignant glioma

    Energy Technology Data Exchange (ETDEWEB)

    Kageji, T. E-mail: kageji@clin.med.tokushima-u.ac.jp; Nagahiro, S.; Mizobuchi, Y.; Toi, H.; Nakagawa, Y.; Kumada, H

    2004-11-01

    The purpose of this study was to clarify the radiation injury in acute or delayed stage after boron neutron capture therapy (BNCT) using mixed epithermal- and thermal neutron beams in patients with malignant glioma. Eighteen patients with malignant glioma underwent mixed epithermal- and thermal neutron beam and sodium borocaptate between 1998 and 2004. The radiation dose (i.e. physical dose of boron n-alpha reaction) in the protocol used between 1998 and 2000 (Protocol A, n=8) prescribed a maximum tumor volume dose of 15 Gy. In 2001, a new dose-escalated protocol was introduced (Protocol B, n=4); it prescribes a minimum tumor volume dose of 18 Gy or, alternatively, a minimum target volume dose of 15 Gy. Since 2002, the radiation dose was reduced to 80-90% dose of Protocol B because of acute radiation injury. A new Protocol was applied to 6 glioblastoma patients (Protocol C, n=6). The average values of the maximum vascular dose of brain surface in Protocol A, B and C were 11.4{+-}4.2 Gy, 15.7{+-}1.2 and 13.9{+-}3.6 Gy, respectively. Acute radiation injury such as a generalized convulsion within 1 week after BNCT was recognized in three patients of Protocol B. Delayed radiation injury such as a neurological deterioration appeared 3-6 months after BNCT, and it was recognized in 1 patient in Protocol A, 5 patients in Protocol B. According to acute radiation injury, the maximum vascular dose was 15.8{+-}1.3 Gy in positive and was 12.6{+-}4.3 Gy in negative. There was no significant difference between them. According to the delayed radiation injury, the maximum vascular dose was 13.8{+-}3.8 Gy in positive and was 13.6{+-}4.9 Gy in negative. There was no significant difference between them. The dose escalation is limited because most patients in Protocol B suffered from acute radiation injury. We conclude that the maximum vascular dose does not exceed over 12 Gy to avoid the delayed radiation injury, especially, it should be limited under 10 Gy in the case that tumor

  14. Tanpopo: A New Micrometeoroid Capture and Astrobiology Exposure in LEO: Its First Year Operation and Post-Flight Plan

    Science.gov (United States)

    Yano, H.; Yamagishi, A.; Hashimoto, H.; Yokobori, S.; Kebukawa, Y.; Kawaguchi, Y.; Kobayashi, K.; Yabuta, H.; Tabata, M.; Higashide, M.; Tanpopo Project Team

    2015-07-01

    Tanpopo conducts micrometeoroid capture with aerogels and microbe exposure for testing quasi-panspermia hypothesis at ISS since May 2015. Samples will be retrieved in 2016-18 for initial analysis at ISAS and detailed analyses at over 25 labs.

  15. Capturing Thoughts, Capturing Minds?

    DEFF Research Database (Denmark)

    Nielsen, Janni

    2004-01-01

    Think Aloud is cost effective, promises access to the user's mind and is the applied usability technique. But 'keep talking' is difficult, besides, the multimodal interface is visual not verbal. Eye-tracking seems to get around the verbalisation problem. It captures the visual focus of attention...

  16. Five years of mental health research in the American Journal of Occupational Therapy, 2009-2013.

    Science.gov (United States)

    Gutman, Sharon A; Raphael-Greenfield, Emily I

    2014-01-01

    In the past 5 years, the number of research articles on occupational therapy in mental health published in the American Journal of Occupational Therapy has steadily declined. This article identifies the strengths and limitations of this body of research and provides directions for practitioners and researchers to enhance the profession's role as a valued mental health service provider.

  17. Development of a dual phantom technique for measuring the fast neutron component of dose in boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sakurai, Yoshinori, E-mail: yosakura@rri.kyoto-u.ac.jp; Tanaka, Hiroki; Kondo, Natsuko; Kinashi, Yuko; Suzuki, Minoru; Masunaga, Shinichiro; Ono, Koji; Maruhashi, Akira [Kyoto University Research Reactor Institute, Asashironishi 2-1010, Kumatori-cho, Sennan-gun, Osaka 590-0494 (Japan)

    2015-11-15

    Purpose: Research and development of various accelerator-based irradiation systems for boron neutron capture therapy (BNCT) is underway throughout the world. Many of these systems are nearing or have started clinical trials. Before the start of treatment with BNCT, the relative biological effectiveness (RBE) for the fast neutrons (over 10 keV) incident to the irradiation field must be estimated. Measurements of RBE are typically performed by biological experiments with a phantom. Although the dose deposition due to secondary gamma rays is dominant, the relative contributions of thermal neutrons (below 0.5 eV) and fast neutrons are virtually equivalent under typical irradiation conditions in a water and/or acrylic phantom. Uniform contributions to the dose deposited from thermal and fast neutrons are based in part on relatively inaccurate dose information for fast neutrons. This study sought to improve the accuracy in the dose estimation for fast neutrons by using two phantoms made of different materials in which the dose components can be separated according to differences in the interaction cross sections. The development of a “dual phantom technique” for measuring the fast neutron component of dose is reported. Methods: One phantom was filled with pure water. The other phantom was filled with a water solution of lithium hydroxide (LiOH) capitalizing on the absorbing characteristics of lithium-6 (Li-6) for thermal neutrons. Monte Carlo simulations were used to determine the ideal mixing ratio of Li-6 in LiOH solution. Changes in the depth dose distributions for each respective dose component along the central beam axis were used to assess the LiOH concentration at the 0, 0.001, 0.01, 0.1, 1, and 10 wt. % levels. Simulations were also performed with the phantom filled with 10 wt. % {sup 6}LiOH solution for 95%-enriched Li-6. A phantom was constructed containing 10 wt. % {sup 6}LiOH solution based on the simulation results. Experimental characterization of the

  18. Mitochondrial compromise in 3-year old patas monkeys exposed in utero to human-equivalent antiretroviral therapies.

    Science.gov (United States)

    Liu, Yongmin; Shim Park, Eunwoo; Gibbons, Alexander T; Shide, Eric D; Divi, Rao L; Woodward, Ruth A; Poirier, Miriam C

    2016-08-01

    Antiretroviral (ARV) drug therapy, given during pregnancy for prevention of mother-to-child transmission of human immunodeficiency virus 1 (HIV-1), induces fetal mitochondrial dysfunction in some children. However, the persistence/reversibility of that dysfunction is unclear. Here we have followed Erythrocebus patas (patas) monkey offspring for up to 3 years of age (similar in development to a 15-year old human) after exposure of the dams to human-equivalent in utero ARV exposure protocols. Pregnant patas dams (3-5/exposure group) were given ARV drug combinations that included zidovudine (AZT)/lamivudine (3TC)/abacavir (ABC), or AZT/3TC/nevirapine (NVP), for the last 10 weeks (50%) of gestation. Infants kept for 1 and 3 years also received drug for the first 6 weeks of life. In offpsring at birth, 1 and 3 years of age mitochondrial morphology, examined by electron microscopy (EM), was compromised compared to the unexposed controls. Mitochondrial DNA (mtDNA), measured by hybrid capture chemiluminescence assay (HCCA) was depleted in hearts of patas exposed to AZT/3TC/NVP at all ages (P year-old patas offspring was ∼50% reduced in AZT/3TC/ABC-exposed patas (P year-old patas sustain persistent mitochondrial dysfunction as a result of perinatal ARV drug exposure. Environ. Mol. Mutagen. 57:526-534, 2016. © 2016 Wiley Periodicals, Inc.

  19. Research Update: Two-Year Follow-up Report for the Wilderness Therapy Program.

    Science.gov (United States)

    Davis-Berman, Jennifer; Berman, Dene S.

    1994-01-01

    Follow-up surveys of 23 adolescent participants in the Wilderness Therapy Program examined self-efficacy, behavioral symptoms, and locus of control at 4 months, 1 year, and 2 years after the program. Results suggest a regression to pretest levels at 4 months, with a return to the original posttest change levels at 1 and 2 years. (Author/SV)

  20. Technological advances in renal replacement therapy: five years and beyond.

    Science.gov (United States)

    Rastogi, Anjay; Nissenson, Allen R

    2009-12-01

    The worldwide epidemic of chronic kidney disease shows no signs of abating in the near future. Current dialysis forms of renal replacement therapy (RRT), even though successful in sustaining life and improving quality of life somewhat for patients with ESRD, have many limitations that result in still unacceptably high morbidity and mortality. Transplantation is an excellent option but is limited by the scarcity of organs. An ideal form of RRT would mimic the functions of natural kidneys and be transparent to the patient, as well as affordable to society. Recent advances in technology, although generally in early stages of development, might achieve these goals. The application of nanotechnology, microfluidics, bioreactors with kidney cells, and miniaturized sorbent systems to regenerate dialysate makes clinical reality seem closer than ever before. Finally, stem cells hold much promise, both for kidney disease and as a source of tissues and organs. In summary, nephrology is at an exciting crossroad with the application of innovative and novel technologies to RRT that hold considerable promise for the near future.

  1. Gain in Quality-adjusted Life-years in Patients with Rheumatoid Arthritis During 1 Year of Biological Therapy

    DEFF Research Database (Denmark)

    Linde, Louise; Sørensen, Jan; Østergaard, Mikkel;

    2013-01-01

    The quality-adjusted life-year (QALY) is used to measure outcome in rheumatoid arthritis (RA) studies; identification of drivers of a gain in QALY might help predict a treatment response. We investigated how changes in components of the Disease Activity Score-28 joints (DAS28) were associated...... with the European League Against Rheumatism (EULAR) and European Quality of Life 5 Dimensions (EQ-5D) responses; and what baseline variables predicted the change in QALY following 1 year of biological therapy....

  2. One year work experience in a municipal Intensive Therapy Unit.

    Directory of Open Access Journals (Sweden)

    Alba Enseñat Alvarez

    2006-04-01

    Full Text Available Background: The Municipal Intensive Care Units were created in the year 2004, to better the urgency attention in the primary health level. Objective: To characterize the functioning of a Municipal Intensive Care Unit. Method: A descriptive, prospective study that included 348 patients that were received in the unit during the year 2004. The following variables were analized: patients evolution, distribution by diseases, and evolution of the diseases. Results and Conclusions: The number of remissions to the hospital dropped; 183 patients weresent to their homes, 165 were remitted to the Provincial Hospital of Cienfuegos and three of them died in the unit. The angina pectoris was the first cause of admission, followed by cardiac arritmias and cerebrovascular disease.

  3. Optimum design and criticality safety of a beam-shaping assembly with an accelerator-driven subcritical neutron multiplier for boron neutron capture therapies.

    Science.gov (United States)

    Hiraga, F

    2015-12-01

    The beam-shaping assembly for boron neutron capture therapies with a compact accelerator-driven subcritical neutron multiplier was designed so that an epithermal neutron flux of 1.9×10(9) cm(-2) s(-1) at the treatment position was generated by 5 MeV protons in a beam current of 2 mA. Changes in the atomic density of (135)Xe in the nuclear fuel due to the operation of the beam-shaping assembly were estimated. The criticality safety of the beam-shaping assembly in terms of Xe poisoning is discussed.

  4. A CONCEPTUAL DESIGN OF NEUTRON COLLIMATOR IN THE THERMAL COLUMN OF KARTINI RESEARCH REACTOR FOR IN VITRO AND IN VIVO TEST OF BORON NEUTRON CAPTURE THERAPY

    OpenAIRE

    Nina Fauziah; Andang Widiharto; Yohannes Sardjono

    2015-01-01

    Studies were carried out to design a collimator which results in epithermal neutron beam for IN VITRO and IN VIVO of Boron Neutron Capture Therapy (BNCT) at the Kartini research reactor by means of Monte Carlo N-Particle (MCNP) codes. Reactor within 100 kW of thermal power was used as the neutron source. The design criteria were based on recommendation from the International Atomic Energy Agency (IAEA). All materials used were varied in size, according to the value of mean free path for each ...

  5. Development of high intensity ion sources for a Tandem-Electrostatic-Quadrupole facility for Accelerator-Based Boron Neutron Capture Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Bergueiro, J. [Gerencia de Investigacion y Aplicaciones, Comision Nacional de Energia Atomica (Argentina)] [CONICET, Buenos Aires (Argentina); Igarzabal, M.; Suarez Sandin, J.C. [Gerencia de Investigacion y Aplicaciones, Comision Nacional de Energia Atomica (Argentina); Somacal, H.R. [Gerencia de Investigacion y Aplicaciones, Comision Nacional de Energia Atomica (Argentina)] [Escuela de Ciencia y Tecnologia, Universidad Nacional de San Martin (Argentina); Thatar Vento, V. [Gerencia de Investigacion y Aplicaciones, Comision Nacional de Energia Atomica (Argentina)] [CONICET, Buenos Aires (Argentina); Huck, H.; Valda, A.A. [Gerencia de Investigacion y Aplicaciones, Comision Nacional de Energia Atomica (Argentina)] [Escuela de Ciencia y Tecnologia, Universidad Nacional de San Martin (Argentina); Repetto, M. [Gerencia de Investigacion y Aplicaciones, Comision Nacional de Energia Atomica (Argentina)

    2011-12-15

    Several ion sources have been developed and an ion source test stand has been mounted for the first stage of a Tandem-Electrostatic-Quadrupole facility For Accelerator-Based Boron Neutron Capture Therapy. A first source, designed, fabricated and tested is a dual chamber, filament driven and magnetically compressed volume plasma proton ion source. A 4 mA beam has been accelerated and transported into the suppressed Faraday cup. Extensive simulations of the sources have been performed using both 2D and 3D self-consistent codes.

  6. Preparation and characterization of Boron carbide nanoparticles for use as a novel agent in T cell-guided boron neutron capture therapy.

    Science.gov (United States)

    Mortensen, M W; Sørensen, P G; Björkdahl, O; Jensen, M R; Gundersen, H J G; Bjørnholm, T

    2006-03-01

    Boron carbide nanoparticles are proposed as a system for T cell-guided boron neutron capture therapy. Nanoparticles were produced by ball milling in various atmospheres of commercially available boron carbide. The physical and chemical properties of the particles were investigated using transmission electron microscopy, photon correlation spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction, vibrational spectroscopy, gel electrophoresis and chemical assays and reveal profound changes in surface chemistry and structural characteristics. In vitro thermal neutron irradiation of B16 melanoma cells incubated with sub-100 nm nanoparticles (381.5 microg/g (10)B) induces complete cell death. The nanoparticles alone induce no toxicity.

  7. Boron neutron capture therapy for clear cell sarcoma (CCS): Biodistribution study of p-borono-L-phenylalanine in CCS-bearing animal models

    Energy Technology Data Exchange (ETDEWEB)

    Andoh, T. [Laboratory of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Cooperative Research Center of Life Sciences, Kobe Gakuin University, Kobe 650-8586 (Japan); Fujimoto, T. [Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-0021 (Japan); Sudo, T. [Section of Translational Research, Hyogo Cancer Center, Akashi 673-0021 (Japan); Fujita, I.; Imabori, M. [Department of Orthopaedic Surgery, Hyogo Cancer Center, Akashi 673-0021 (Japan); Moritake, H. [Department of Pediatrics, Miyazaki University, Kiyotake 889-1692 (Japan); Sugimoto, T. [Department of Pediatrics, Saiseikai Shigaken Hospital, Ritto 520-3046 (Japan); Sakuma, Y. [Department of Pathology, Hyogo Cancer Center, Akashi 673-0021 (Japan); Takeuchi, T. [Department of Pathology, Kochi University, Nangoku 783-8505 (Japan); Kawabata, S. [Department of Neurosurgery, Osaka Medical College, Osaka 569-8686 (Japan); Kirihata, M. [Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Sakai 599-8531 (Japan); Akisue, T. [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017 (Japan); Yayama, K. [Laboratory of Cardiovascular Pharmacology, Faculty of Pharmaceutical Sciences and Cooperative Research Center of Life Sciences, Kobe Gakuin University, Kobe 650-8586 (Japan); Kurosaka, M. [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017 (Japan); Miyatake, S. [Department of Neurosurgery, Osaka Medical College, Osaka 569-8686 (Japan); Fukumori, Y. [Laboratory of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Cooperative Research Center of Life Sciences, Kobe Gakuin University, Kobe 650-8586 (Japan); Ichikawa, H., E-mail: ichikawa@pharm.kobegakuin.ac.jp [Laboratory of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Cooperative Research Center of Life Sciences, Kobe Gakuin University, Kobe 650-8586 (Japan)

    2011-12-15

    Clear cell sarcoma (CCS) is a rare melanocytic malignant tumor with a poor prognosis. Our previous study demonstrated that in vitro cultured CCS cells have the ability to highly uptake L-BPA and thus boron neutron capture therapy could be a new option for CCS treatment. This paper proved that a remarkably high accumulation of {sup 10}B (45-74 ppm) in tumor was obtained even in a CCS-bearing animal with a well-controlled biodistribution followed by intravenous administration of L-BPA-fructose complex (500 mg BPA/kg).

  8. Synthesis and evaluation of boron compounds for neutron capture therapy of malignant brain tumors. Technical progress report No. 1, May 1, 1990--January 31, 1991

    Energy Technology Data Exchange (ETDEWEB)

    Soloway, A.H.; Barth, R.F.

    1990-12-31

    Boron neutron capture therapy offers the potentiality for treating brain tumors currently resistant to treatment. The success of this form of therapy is directly dependent upon the delivery of sufficient numbers of thermal-neutrons to tumor cells which possess high concentrations of B-10. The objective of this project is to develop chemical methodology to synthesize boron-containing compounds with the potential for becoming incorporated into rapidly-dividing malignant brain tumor cells and excluded from normal components of the brain and surrounding tissues, to develope biological methods for assessing the potential of the compound by use of cell culture or intratumoral injection, to develop analytical methodology for measuring boron in cells and tissue using direct current plasma atomic emission spectroscopy (DCP-AES) and alpha track autoradiography, to develop biochemical and HPLC procedures for evaluating compound uptake and tissue half-life, and to develop procedures required to assess both in vitro and vivo efficacy of BNCT with selected compounds.

  9. Characterisation of neutron and gamma-ray emission from thick target Be(p,n) reaction for boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Guzek, J.; Mateva, T.; Tapper, U.A.S. [De Beers Diamond Res. Lab., Southdale (South Africa); McMurray, W.R. [National Accelerator Centre, Van de Graaff Group, P.O. Box 72, Faure 7131 (South Africa); Franklyn, C.B. [Atomic Energy Corporation of South Africa, P.O. Box 582, Pretoria (South Africa)

    1998-04-01

    Low energy accelerator-based neutron sources have promising potential for use in a clinical treatment of cancer with boron neutron capture therapy (BNCT) and boron neutron capture synovectomy (BNCS). Such sources often utilise a thick target Be(p,n) reaction using incident proton energies from several hundred keV to 1-2 MeV above the reaction threshold of 2.06 MeV. The resulting neutron and gamma-ray beams require considerable moderation and filtration in order to obtain thermal and epithermal neutron fluxes for therapy. The detailed knowledge of neutron and gamma-ray spectra, yield and angular distribution are necessary in order to design effective moderators and filters to be used for the treatment. Thick and thin beryllium target neutron and gamma spectra have been investigated in detail using the time-of-flight (TOF) technique, for incident proton energies from above threshold to 4 MeV. The results show characteristics of neutron and gamma-ray production of importance for the application of this neutron source for BNCT and BNCS. (orig.) 6 refs.

  10. Microanalysis system of ppm-order 10B concentrations in tissue for neutron capture therapy by prompt gamma-ray spectrometry

    Science.gov (United States)

    Kobayashi, Tooru; Kanda, Keiji

    1983-01-01

    For neutron capture therapy, a new technique for measuring 10B concentrations of ppm order in tissue has been developed by using 10B(n, α) 7Li ∗ prompt gamma-ray spectrometry. The measuring system consists of a Ge(Li) detector and a 6LiF tile neutron shield attached to the neutron guide tube of the Kyoto University Reactor (KUR) with very low background gamma-rays. The 10B concentrations of unknown samples were determined in comparison with gamma-ray data obtained from known samples. The detection limit of the system is 0.1-0.5 ppm 10B concentration. In the practical use of the system for neutron capture therapy, 10B concentrations of 10 ppm, which is ordinarily pre-injected into the tumor, can be measured in less than 30 s with 10% accuracy by using 1 g samples. Moreover, the system has the advantage that pre-treatment of the sample is not required. As a neutron monitor in a homogeneous sample, gamma-rays emitted from H(n, γ)D reactions are used. Therefore, neutron irradiation conditions of this system, i.e. fluence rate, energy spectrum, and distribution in the sample do not affect the analyzing results, and the quantity and dimensions of the sample are also not restricted.

  11. A microdosimetric study of {sup 10}B(n,{alpha}){sup 7}Li and {sup 157}Gd(n,{gamma}) reactions for neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Wang, C.K.C.; Sutton, M.; Evans, T.M. [Georgia Inst. of Tech., Atlanta, GA (United States); Laster, B.H. [Brookhaven National Lab., Upton, NY (United States). Medical Dept.

    1999-01-01

    This paper presents the microdosimetric analysis for the most interesting cell survival experiment recently performed at the Brookhaven National Laboratory (BNL). In this experiment, the cells were first treated with a gadolinium (Gd) labeled tumor-seeking boronated porphyrin (Gd-BOPP) or with BOPP alone, and then irradiated with thermal neutrons. The resulting cell-survival curves indicate that the {sup 157}Gd(n,{gamma}) reactions are very effective in cell killing. The death of a cell treated with Gd-BOPP was attributed to either the {sup 10}B(n,{alpha}){sup 7}Li reactions or the {sup 157}Gd(n,{gamma}) reactions (or both). However, the quantitative relationship between the two types of reaction and the cell-survival fraction was not clear. This paper presents the microdosimetric analysis for the BNL experiment based on the measured experimental parameters, and the results clearly suggest a quantitative relationship between the two types of reaction and the cell survival fraction. The results also suggest new research in gadolinium neutron capture therapy (GdNCT) which may lead to a more practical modality than the boron neutron capture therapy (BNCT) for treating cancers.

  12. Processes and outcomes of psychotherapists' personal therapy: Replication and extension 20 years later.

    Science.gov (United States)

    Bike, Denise H; Norcross, John C; Schatz, Danielle M

    2009-03-01

    In this replication and extension of a national survey of psychotherapists conducted in 1987, American psychologists (n = 219), counselors (n = 191), and social workers (n = 192) reported in 2007 on the processes and outcomes of their personal therapy experiences. Of the 85% who sought therapy at least once, women, men, and members of all three professions were equally as likely to have received personal treatment. Their top reasons for seeking therapy were marital-couple distress (20%), depression (13%), need for self-understanding (12%), and anxiety-stress (10%). Approximately 24% used psychotropic medication in combination with personal therapy. More than 90% of therapists reported positive outcomes across multiple domains. The modal lasting lessons from personal treatment related to therapist reliability, skill, and empathy. The results are tentatively compared with those obtained in 1987, thus chronicling the evolution of personal therapy among psychologists and social workers during the past 20 years. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  13. Feasibility and Use of the Mobile Food Record for Capturing Eating Occasions among Children Ages 3–10 Years in Guam

    Directory of Open Access Journals (Sweden)

    Tanisha F. Aflague

    2015-06-01

    Full Text Available Children’s readiness to use technology supports the idea of children using mobile applications for dietary assessment. Our goal was to determine if children 3–10 years could successfully use the mobile food record (mFR to capture a usable image pair or pairs. Children in Sample 1 were tasked to use the mFR to capture an image pair of one eating occasion while attending summer camp. For Sample 2, children were tasked to record all eating occasions for two consecutive days at two time periods that were two to four weeks apart. Trained analysts evaluated images. In Sample 1, 90% (57/63 captured one usable image pair. All children (63/63 returned the mFR undamaged. Sixty-two children reported: The mFR was easy to use (89%; willingness to use the mFR again (87%; and the fiducial marker easy to manage (94%. Children in Sample 2 used the mFR at least one day at Time 1 (59/63, 94%; Time 2 (49/63, 78%; and at both times (47/63, 75%. This latter group captured 6.21 ± 4.65 and 5.65 ± 3.26 mean (±SD image pairs for Time 1 and Time 2, respectively. Results support the potential for children to independently record dietary intakes using the mFR.

  14. Synapse-specific stabilization of plasticity processes: the synaptic tagging and capture hypothesis revisited 10 years later.

    Science.gov (United States)

    Barco, Angel; Lopez de Armentia, Mikel; Alarcon, Juan M

    2008-01-01

    A decade ago, the synaptic tagging hypothesis was proposed to explain how newly synthesized plasticity products can be specifically targeted to active synapses. A growing number of studies have validated the seminal findings that gave rise to this model, as well as contributed to unveil and expand the range of mechanisms underlying late-associativity and neuronal computation. Here, we will review what it was learnt during this past decade regarding the cellular and molecular mechanisms underlying synaptic tagging and synaptic capture. The accumulated experimental evidence has widened the theoretical framework set by the synaptic tagging and capture (STC) model and introduced concepts that were originally considered part of alternative models for explaining synapse-specific long-term potentiation (LTP). As a result, we believe that the STC model, now improved and expanded with these new ideas and concepts, still represents the most compelling hypothesis to explain late-associativity in synapse-specific plasticity processes. We will also discuss the impact of this model in our view of the integrative capability of neurons and associative learning.

  15. Initial monotherapy and combination therapy and hypertension control the first year.

    Science.gov (United States)

    Egan, Brent M; Bandyopadhyay, Dipankar; Shaftman, Stephanie R; Wagner, C Shaun; Zhao, Yumin; Yu-Isenberg, Kristina S

    2012-06-01

    Initial antihypertensive therapy with single-pill combinations produced more rapid blood pressure control than initial monotherapy in clinical trials. Other studies reported better cardiovascular outcomes in patients achieving lower blood pressure during the first treatment year. We assessed the effectiveness of initial antihypertensive monotherapy, free combinations, and single-pill combinations in controlling untreated, uncontrolled hypertensives during their first treatment year. Electronic record data were obtained from 180 practice sites; 106 621 hypertensive patients seen from January 2004 to June 2009 had uncontrolled blood pressure, were untreated for ≥ 6 months before therapy, and had ≥ 1 one-year follow-up blood pressure data. Control was determined by the first follow-up visit with blood pressure blood pressure, body mass index, diabetes mellitus, chronic kidney disease, cardiovascular disease, initial therapy, final blood pressure medication number, and therapeutic inertia. Patients on initial single-pill combinations (N = 9194) were more likely to have stage 2 hypertension than those on free combinations (N = 18 328) or monotherapy (N = 79 099; all Phypertension control in the first year than free combinations (HR, 1.34; [95% CI, 1.31-1.37]) or monotherapy (reference) with benefits in black and white patients. Greater use of single-pill combinations as initial therapy may improve hypertension control and cardiovascular outcomes in the first treatment year.

  16. Computer animated relaxation therapy in children between 7 and 13 years with tension-type headache

    DEFF Research Database (Denmark)

    Tornoe, Birte; Skov, Liselotte

    2012-01-01

    This pilot study evaluated the effect of computer animated relaxation therapy in children between 7 and 13 years with tension-type headache and the children's experiences with the therapy. The therapy consisted of an uncontrolled nine-session course in modified progressive relaxation therapy...... assisted by computer animated surface EMG provided from the trapezius muscles and with the physiotherapist as a participant observer. Outcome measures were (a) headache frequency and intensity, (b) pericranial tenderness, (c) tension patterns, and (d) evaluations assessed at baseline and at 3 months follow...... participants and in Total Tenderness Score for children with frequent episodic tension-type headache. The children expressed a growing understanding of body reactions and an acquired ability to deactivate and regulate these reactions. Computer animated SEMG seems an applicable learning strategy for young...

  17. Development of an optical fiber type detector using a Eu:LiCaAlF{sub 6} scintillator for neutron monitoring in boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Kenichi, E-mail: k-watanabe@nucl.nagoya-u.ac.jp [Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8603 (Japan); Kawabata, Yuya; Yamazaki, Atsushi; Uritani, Akira; Iguchi, Tetsuo [Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8603 (Japan); Fukuda, Kentaro [Tokuyama Corp., 1-1 Mikage-cho, Shunan-shi, Yamaguchi, 745-8648 (Japan); Yanagida, Takayuki [Nara Institute of Science and Technology, 8916-5 Takayama, Ikoma, Nara, 630-0192 (Japan)

    2015-12-01

    We have developed a small neutron detector probe as a thermal neutron flux monitor for boron neutron capture therapy. The detector consists of an optical fiber and a small Eu:LiCaAlF{sub 6} scintillator. In order to improve neutron-gamma ray discrimination capability, we use the small-size scintillator, whose size is controlled to be smaller than fast electron range produced by gamma-rays and larger than the range of charged particles induced by {sup 6}Li(n,t) reactions. We confirmed the improved neutron-gamma ray discrimination capability by comparing the detector responses between a small-size scintillator and a slab one. We also evaluated the neutron sensitivity of the fabricated optical fiber type neutron detector to be 2×10{sup −4} cm{sup 2}.

  18. Monitoring the distribution of prompt gamma rays in boron neutron capture therapy using a multiple-scattering Compton camera: A Monte Carlo simulation study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Taewoong; Lee, Hyounggun; Lee, Wonho, E-mail: wonhol@korea.ac.kr

    2015-10-21

    This study evaluated the use of Compton imaging technology to monitor prompt gamma rays emitted by {sup 10}B in boron neutron capture therapy (BNCT) applied to a computerized human phantom. The Monte Carlo method, including particle-tracking techniques, was used for simulation. The distribution of prompt gamma rays emitted by the phantom during irradiation with neutron beams is closely associated with the distribution of the boron in the phantom. Maximum likelihood expectation maximization (MLEM) method was applied to the information obtained from the detected prompt gamma rays to reconstruct the distribution of the tumor including the boron uptake regions (BURs). The reconstructed Compton images of the prompt gamma rays were combined with the cross-sectional images of the human phantom. Quantitative analysis of the intensity curves showed that all combined images matched the predetermined conditions of the simulation. The tumors including the BURs were distinguishable if they were more than 2 cm apart.

  19. Controllability of depth dose distribution for neutron capture therapy at the Heavy Water Neutron Irradiation Facility of Kyoto University Research Reactor.

    Science.gov (United States)

    Sakurai, Yoshinori; Kobayashi, Tooru

    2002-10-01

    The updating construction of the Heavy Water Neutron Irradiation Facility of the Kyoto University Research Reactor has been performed from November 1995 to March 1996 mainly for the improvement in neutron capture therapy. On the performance, the neutron irradiation modes with the variable energy spectra from almost pure thermal to epi-thermal neutrons became available by the control of the heavy-water thickness in the spectrum shifter and by the open-and-close of the cadmium and boral thermal neutron filters. The depth distributions of thermal, epi-thermal and fast neutron fluxes were measured by activation method using gold and indium, and the depth distributions of gamma-ray absorbed dose rate were measured using thermo-luminescent dosimeter of beryllium oxide for the several irradiation modes. From these measured data, the controllability of the depth dose distribution using the spectrum shifter and the thermal neutron filters was confirmed.

  20. Improved methods for the generation of 24.5 keV neutron beams with possible application to boron neutron capture therapy

    Science.gov (United States)

    Constantine, G.; Baker, L. J.; Taylor, N. P.

    1986-09-01

    The production of epithermal neutron beams, filtered to provide a spectrum in which a small energy range predominates, is of importance for radiobiological research and in the development and calibration of instruments for monitoring intermediate energy neutrons. The penetration characteristics of intermediate energy neutrons in tissue lead to the possibility of application in the field of neutron capture therapy if beams of sufficient intensity and adequate spectral properties can be generated. In this paper methods of utilising the 24.5 keV antiresonance in the iron neutron cross section are described, and the DENIS (depth enhanced neutron intense source) principle by which beam intensities may be optimised is explained. Calculations and experimental measurements in an in-core facility in the DIDO reactor at Harwell have indicated that a DENIS scatterer can achieve a 6-fold improvement in 24.5 keV beam intensity compared with a conventional titanium disc scatterer.

  1. A conceptual design of a beam-shaping assembly for boron neutron capture therapy based on deuterium-tritium neutron generators.

    Science.gov (United States)

    Martín, Guido; Abrahantes, Arian

    2004-05-01

    A conceptual design of a beam-shaping assembly for boron neutron capture therapy using deuterium-tritium accelerator based neutrons source is developed. Calculations based on a simple geometry model for the radiation transport are initially performed to estimate the assembly materials and their linear dimensions. Afterward, the assembly geometry is produced, optimized and verified. In order to perform these calculations the general-purpose MCNP code is used. Irradiation time and therapeutic gain are utilized as beam assessment parameters. Metallic uranium and manganese are successfully tested for fast-to-epithermal neutron moderation. In the present beam-shaping assembly proposal, the therapeutic gain is improved by 23% and the accelerator current required for a fixed irradiation period is reduced by six times compared to previous proposals based on the same D-T reaction.

  2. Quantitative bioimaging of p-boronophenylalanine in thin liver tissue sections as a tool for treatment planning in boron neutron capture therapy.

    Science.gov (United States)

    Reifschneider, Olga; Schütz, Christian L; Brochhausen, Christoph; Hampel, Gabriele; Ross, Tobias; Sperling, Michael; Karst, Uwe

    2015-03-01

    An analytical method using laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) was developed and applied to assess enrichment of 10B-containing p-boronophenylalanine-fructose (BPA-f) and its pharmacokinetic distribution in human tissues after application for boron neutron capture therapy (BNCT). High spatial resolution (50 μm) and limits of detection in the low parts-per-billion range were achieved using a Nd:YAG laser of 213 nm wavelength. External calibration by means of 10B-enriched standards based on whole blood proved to yield precise quantification results. Using this calibration method, quantification of 10B in cancerous and healthy tissue was carried out. Additionally, the distribution of 11B was investigated, providing 10B enrichment in the investigated tissues. Quantitative imaging of 10B by means of LA-ICP-MS was demonstrated as a new option to characterise the efficacy of boron compounds for BNCT.

  3. Synthesis and characterization of gadolinium nanostructured materials with potential applications in magnetic resonance imaging, neutron-capture therapy and targeted drug delivery

    Energy Technology Data Exchange (ETDEWEB)

    Stefanakis, Dimitrios; Ghanotakis, Demetrios F., E-mail: ghanotakis@chemistry.uoc.g [University of Crete, Department of Chemistry (Greece)

    2010-05-15

    Two Gadolinium nanostructured materials, Gd{sub 2}(OH){sub 5}NO{sub 3} nanoparticles and Gd(OH){sub 3} nanorods, were synthesized and extensively characterized by various techniques. In addition to the potential use of Gd{sub 2}(OH){sub 5}NO{sub 3} in magnetic resonance imaging (MRI) and Neutron-capture therapy (NCT) application, it could also be used in targeted drug delivery. An antibiotic (nalidixic acid), two amino acids (aspartic and glutamic acid), a fatty acid and a surfactant (SDS) were intercalated in the nanoparticles. The surface of the nanoparticles was modified with folic acid in order to be capable of targeted delivery to folate receptor expressing sites, such as tumor human cells.

  4. CAPTURED End Evaluation Synthesis Report

    NARCIS (Netherlands)

    Brouwers, J.H.A.M.

    2012-01-01

    This report provides the findings of the Synthesis Study of the CAPTURED Evaluation and is produced as part of the overall CAPTURED End Evaluation. After five years of support by the CAPTURED project the three CAPTURED partners have achieved commendable results. Ten lessons learned are formulated th

  5. Anthroposophic therapy for chronic depression: a four-year prospective cohort study

    Directory of Open Access Journals (Sweden)

    Willich Stefan N

    2006-12-01

    Full Text Available Abstract Background Depressive disorders are common, cause considerable disability, and do not always respond to standard therapy (psychotherapy, antidepressants. Anthroposophic treatment for depression differs from ordinary treatment in the use of artistic and physical therapies and special medication. We studied clinical outcomes of anthroposophic therapy for depression. Methods 97 outpatients from 42 medical practices in Germany participated in a prospective cohort study. Patients were aged 20–69 years and were referred to anthroposophic therapies (art, eurythmy movement exercises, or rhythmical massage or started physician-provided anthroposophic therapy (counselling, medication for depression: depressed mood, at least two of six further depressive symptoms, minimum duration six months, Center for Epidemiological Studies Depression Scale, German version (CES-D, range 0–60 points of at least 24 points. Outcomes were CES-D (primary outcome and SF-36 after 3, 6, 12, 18, 24, and 48 months. Data were collected from July 1998 to March 2005. Results Median number of art/eurythmy/massage sessions was 14 (interquartile range 12–22, median therapy duration was 137 (91–212 days. All outcomes improved significantly between baseline and all subsequent follow-ups. Improvements from baseline to 12 months were: CES-D from mean (standard deviation 34.77 (8.21 to 19.55 (13.12 (p Conclusion In outpatients with chronic depression, anthroposophic therapies were followed by long-term clinical improvement. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study findings suggest that the anthroposophic approach, with its recourse to non-verbal and artistic exercising therapies can be useful for patients motivated for such therapies.

  6. Cosmetic outcome 1-5 years after breast conservative surgery, irradiation and systemic therapy.

    Science.gov (United States)

    Kelemen, Gyöngyi; Varga, Zoltán; Lázár, György; Thurzó, László; Kahán, Zsuzsanna

    2012-04-01

    The late side-effects of the local therapy of early breast cancer depend on many patient- and therapy-related parameters. We aimed at investigating the factors that influence the cosmetic and functional outcomes among our breast cancer patients after breast-conserving surgery and conformal radiotherapy, with or without adjuvant systemic therapy. A study was made of the association of the cosmetic outcome after a median follow-up time of 2.4 years and the clinical data on 198 patients extracted from a prospectively compiled database. Breast tenderness occurred more frequently among patients ≤50 years old (p cosmetic outcome after breast-conserving surgery and postoperative radiotherapy.

  7. Eurythmy therapy in chronic disease: a four-year prospective cohort study

    Directory of Open Access Journals (Sweden)

    Willich Stefan N

    2007-04-01

    Full Text Available Abstract Background Many patients with chronic diseases use complementary therapies, often provided by their physicians. In Germany, several physician-provided complementary therapies have been reimbursed by health insurance companies as part of health benefit programs. In most of these therapies, the patient has a predominantly passive role. In eurythmy therapy, however, patients actively exercise specific movements with the hands, the feet or the whole body. The purpose of this study was to describe clinical outcomes in patients practising eurythmy therapy exercises for chronic diseases. Methods In conjunction with a health benefit program, 419 outpatients from 94 medical practices in Germany, referred to 118 eurythmy therapists, participated in a prospective cohort study. Main outcomes were disease severity (Disease and Symptom Scores, physicians' and patients' assessment on numerical rating scales 0–10 and quality of life (adults: SF-36, children aged 8–16: KINDL, children 1–7: KITA. Disease Score was documented after 0, 6 and 12 months, other outcomes after 0, 3, 6, 12, 18, 24, and (SF-36 and Symptom Score 48 months. Results Most common indications were mental disorders (31.7% of patients; primarily depression, fatigue, and childhood emotional disorder and musculoskeletal diseases (23.4%. Median disease duration at baseline was 3.0 years (interquartile range 1.0–8.5. Median number of eurythmy therapy sessions was 12 (interquartile range 10–19, median therapy duration was 119 days (84–188. All outcomes improved significantly between baseline and all subsequent follow-ups (exceptions: KITA Psychosoma in first three months and KINDL. Improvements from baseline to 12 months were: Disease Score from mean (standard deviation 6.65 (1.81 to 3.19 (2.27 (p Adverse reactions to eurythmy therapy occurred in 3.1% (13/419 of patients. No patient stopped eurythmy therapy due to adverse reactions. Conclusion Patients practising eurythmy therapy

  8. Phage Therapy in Bacterial Infections Treatment: One Hundred Years After the Discovery of Bacteriophages.

    Science.gov (United States)

    Cisek, Agata Anna; Dąbrowska, Iwona; Gregorczyk, Karolina Paulina; Wyżewski, Zbigniew

    2017-02-01

    The therapeutic use of bacteriophages has seen a renewal of interest blossom in the last few years. This reversion is due to increased difficulties in the treatment of antibiotic-resistant strains of bacteria. Bacterial resistance to antibiotics, a serious problem in contemporary medicine, does not implicate resistance to phage lysis mechanisms. Lytic bacteriophages are able to kill antibiotic-resistant bacteria at the end of the phage infection cycle. Thus, the development of phage therapy is potentially a way to improve the treatment of bacterial infections. However, there are antibacterial phage therapy difficulties specified by broadening the knowledge of the phage nature and influence on the host. It has been shown during experiments that both innate and adaptive immunity are involved in the clearance of phages from the body. Immunological reactions against phages are related to the route of administration and may vary depending on the type of bacterial viruses. For that reason, it is very important to test the immunological response of every single phage, particularly if intravenous therapy is being considered. The lack of these data in previous years was one of the reasons for phage therapy abandonment despite its century-long study. Promising results of recent research led us to look forward to a phage therapy that can be applied on a larger scale and subsequently put it into practice.

  9. Composite veneers, crowns, and inlay bridges after orthodontic therapy--a three-year prospective study.

    Science.gov (United States)

    Dostálová, Tat'jana; Racek, Jaroslav; Lozeková, Eva; Rerichová, Martina

    2003-01-01

    Composite veneers, crowns, and adhesive bridges also can be a part of interdisciplinary therapy, namely, cooperation between orthodontics and prosthodontics. This study sought to systematically analyze patients treated orthodontically and prosthodontically with permanent teeth from a long-term point of view (three years). Forty-nine composite veneers, crowns, and adhesive bridges were inserted on the anterior teeth of 20 patients as a part of reshaping and reorientation of teeth after orthodontic therapy. The results indicated that composite resin restoration, including fiber-reinforcement restoration, is the treatment of choice in anterior dentition.

  10. CAPTURED India Country Evaluation

    NARCIS (Netherlands)

    O'Donoghue, R.; Brouwers, J.H.A.M.

    2012-01-01

    This report provides the findings of the India Country Evaluation and is produced as part of the overall CAPTURED End Evaluation. After five years of support by the CAPTURED project the End Evaluation has assessed that results are commendable. I-AIM was able to design an approach in which health fol

  11. Folate receptor-mediated boron-10 containing carbon nanoparticles as potential delivery vehicles for boron neutron capture therapy of nonfunctional pituitary adenomas.

    Science.gov (United States)

    Dai, Congxin; Cai, Feng; Hwang, Kuo Chu; Zhou, Yongmao; Zhang, Zizhu; Liu, Xiaohai; Ma, Sihai; Yang, Yakun; Yao, Yong; Feng, Ming; Bao, Xinjie; Li, Guilin; Wei, Junji; Jiao, Yonghui; Wei, Zhenqing; Ma, Wenbin; Wang, Renzhi

    2013-02-01

    Invasive nonfunctional pituitary adenomas (NFPAs) are difficult to completely resect and often develop tumor recurrence after initial surgery. Currently, no medications are clinically effective in the control of NFPA. Although radiation therapy and radiosurgery are useful to prevent tumor regrowth, they are frequently withheld because of severe complications. Boron neutron capture therapy (BNCT) is a binary radiotherapy that selectively and maximally damages tumor cells without harming the surrounding normal tissue. Folate receptor (FR)-targeted boron-10 containing carbon nanoparticles is a novel boron delivery agent that can be selectively taken up by FR-expressing cells via FR-mediated endocytosis. In this study, FR-targeted boron-10 containing carbon nanoparticles were selectively taken up by NFPAs cells expressing FR but not other types of non-FR expressing pituitary adenomas. After incubation with boron-10 containing carbon nanoparticles and following irradiation with thermal neutrons, the cell viability of NFPAs was significantly decreased, while apoptotic cells were simultaneously increased. However, cells administered the same dose of FR-targeted boron-10 containing carbon nanoparticles without neutron irradiation or received the same neutron irradiation alone did not show significant decrease in cell viability or increase in apoptotic cells. The expression of Bcl-2 was down-regulated and the expression of Bax was up-regulated in NFPAs after treatment with FR-mediated BNCT. In conclusion, FR-targeted boron-10 containing carbon nanoparticles may be an ideal delivery system of boron to NFPAs cells for BNCT. Furthermore, our study also provides a novel insight into therapeutic strategies for invasive NFPA refractory to conventional therapy, while exploring these new applications of BNCT for tumors, especially benign tumors.

  12. [The combined DAK therapy of obesity for children and adolescents. Evaluation after 1 year].

    Science.gov (United States)

    Adam, S; Westenhöfer, J; Rudolphi, B; Kraaibeek, H K

    2008-04-10

    In 2003, the program "The combined DAK therapy of obesity for children and adolescents", funded and conducted by the Deutsche Angestellten Krankenkasse (DAK) (A German Health Insurance Company), has started. The whole treatment lasts for 1 year including an initial inpatient therapy for 6 weeks followed by an outpatient treatment at home that adresses the overweight patients and their families. The therapy contents are developed according to the recommendations of the "Arbeitsgemeinschaft Adipositas im Kindes- und Jugendalter (AGA)". In a prospective cohort study a sample of 604 subjects was studied in order to examine the achievement of the treatment goals weight reduction, behaviour modification and improvement of quality of life. The development of weight was evaluated using BMI-SDS. 44,1% of children and adolescents had a successful weight reduction, they reduced their weight at least by 0,3 BMI-SDS. Furthermore, significant changes of health behaviour, physical fitness and quality of life were observed. However, during the outpatient treatment an impairment of some behaviour changes were observed. Nevertheless, the study has identified significant, positive effects in weight loss, behaviour modifications, changes in physical fitness and in the development of quality of life as a result of the therapy. It is demonstrated that a relapse in "old behaviour" followed by an increase of weight after the inpatient treatment can be avoided bythe subsequent outpatient therapy.

  13. Overview of Clinical Application of Chiropractic Therapy in the Past ten Years

    Institute of Scientific and Technical Information of China (English)

    ZHOU Er-chun

    2004-01-01

    捏脊疗法是推拿常用手法之一,这一疗法具有简、便、验、廉的特点.近年来捏脊疗法临床应用的范围不断扩大,用于治疗的疾病已达数十种.遍及内科、妇科、儿科等各科及预防、保健、美容等方面,临床报道很多.本文收集近十年有关捏脊疗法的文献21篇,在分析了这些文献的基础上从捏脊疗法临床运用的角度进行归纳总结.%Chiropractic therapy is a common massage method of simplicity, convenience, efficacy and low cost. In the past years, chiropractic therapy is increasingly used to treat many diseases in relation to internal medicine, gynecology, pediatrics, medical prevention, healthcare and cosmetology, etc.This paper collects 21 articles concerning chiropractic therapy in the past 10 years, and then sums up the clinical application of chiropractic therapy.

  14. Sensitivity studies of beam directionality, beam size, and neutron spectrum for a fission converter-based epithermal neutron beam for boron neutron capture therapy.

    Science.gov (United States)

    Sakamoto, S; Kiger, W S; Harling, O K

    1999-09-01

    Sensitivity studies of epithermal neutron beam performance in boron neutron capture therapy are presented for realistic neutron beams with varying filter/moderator and collimator/delimiter designs to examine the relative importance of neutron beam spectrum, directionality, and size. Figures of merit for in-air and in-phantom beam performance are calculated via the Monte Carlo technique for different well-optimized designs of a fission converter-based epithermal neutron beam with head phantoms as the irradiation target. It is shown that increasing J/phi, a measure of beam directionality, does not always lead to corresponding monotonic improvements in beam performance. Due to the relatively low significance, for most configurations, of its effect on in-phantom performance and the large intensity losses required to produce beams with very high J/phi, beam directionality should not be considered an important figure of merit in epithermal neutron beam design except in terms of its consequences on patient positioning and collateral dose. Hardening the epithermal beam spectrum, while maintaining the specific fast neutron dose well below the inherent hydrogen capture dose, improves beam penetration and advantage depth and, as a desirable by-product, significantly increases beam intensity. Beam figures of merit are shown to be strongly dependent on beam size relative to target size. Beam designs with J/phi approximately 0.65-0.7, specific fast neutron doses of 2-2.6x10(-13) Gy cm2/n and beam sizes equal to or larger than the size of the head target produced the deepest useful penetration, highest therapeutic ratios, and highest intensities.

  15. Capture reactions

    NARCIS (Netherlands)

    Endt, P.M.

    1956-01-01

    Capture reactions will be considered here from the viewpoint of the nuclear spectroscopist. Especially important to him are the capture of neutrons, protons, and alpha particles, which may proceed through narrow resonances, offering a well defined initial state for the subsequent deexcitation proces

  16. Changes in flow experience among occupational therapy students: a 1-year longitudinal study

    Directory of Open Access Journals (Sweden)

    Kazuki Hirao

    2014-07-01

    Full Text Available Purpose: The purpose of this 1-year longitudinal study is to investigate the change in flow experience among occupational therapy students (OTS. Methods: In December 2012, we prospectively recruited 97 OTS from the Department of Occupational Therapy, Kibi International University. To assess flow experience in daily life, we used the Flow Experience Checklist. Results: The dataset included 87 OTS, of which 75 participated in the assessment at 1 year (follow-up rate, 86.2%. The mean age at baseline of 45 male and 30 female OTS was 19.59±1.1 years (range, 18 to 24 years. A comparison of the ‘frequency of flow experience’ showed significant differences between baseline values and those after 1 year (December 2013 among male OTS (P<0.05. Conclusion: The present results indicate that, for male OTS, the frequency of flow was significantly reduced after 1 year compared with baseline values. This finding suggests the need for further education to increase the frequency of flow among male OTS.

  17. Assessment of the cardiovascular effects of electroconvulsive therapy in individuals older than 50 years

    Directory of Open Access Journals (Sweden)

    Takada J.Y.

    2005-01-01

    Full Text Available To evaluate the impact of electroconvulsive therapy on arterial blood pressure, heart rate, heart rate variability, and the occurrence of ischemia or arrhythmias, 38 (18 men depressive patients free from systemic diseases, 50 to 83 years old (mean: 64.7 ± 8.6 underwent electroconvulsive therapy. All patients were studied with simultaneous 24-h ambulatory blood pressure and Holter monitoring, starting 18 h before and continuing for 3 h after electroconvulsive therapy. Blood pressure, heart rate, heart rate variability, arrhythmias, and ischemic episodes were recorded. Before each session of electroconvulsive therapy, blood pressure and heart rate were in the normal range; supraventricular ectopic beats occurred in all patients and ventricular ectopic beats in 27/38; 2 patients had non-sustained ventricular tachycardia. After shock, systolic, mean and diastolic blood pressure increased 29, 25, and 24% (P < 0.001, respectively, and returned to baseline values within 1 h. Maximum, mean and minimum heart rate increased 56, 52, and 49% (P < 0.001, respectively, followed by a significant decrease within 5 min; heart rate gradually increased again thereafter and remained elevated for 1 h. Analysis of heart rate variability showed increased sympathetic activity during shock with a decrease in both sympathetic and parasympathetic drive afterwards. No serious adverse effects occurred; electroconvulsive therapy did not trigger any malignant arrhythmias or ischemia. In middle-aged and elderly people free from systemic diseases, electroconvulsive therapy caused transitory increases in blood pressure and heart rate and a decrease in heart rate variability but these changes were not associated with serious adverse clinical events.

  18. High dengue case capture rate in four years of a cohort study in Nicaragua compared to national surveillance data.

    Directory of Open Access Journals (Sweden)

    Katherine Standish

    Full Text Available Dengue is a major public health problem in tropical and subtropical regions; however, under-reporting of cases to national surveillance systems hinders accurate knowledge of disease burden and costs. Laboratory-confirmed dengue cases identified through the Nicaraguan Pediatric Dengue Cohort Study (PDCS were compared to those reported from other health facilities in Managua to the National Epidemiologic Surveillance (NES program of the Nicaraguan Ministry of Health. Compared to reporting among similar pediatric populations in Managua, the PDCS identified 14 to 28 (average 21.3 times more dengue cases each year per 100,000 persons than were reported to the NES. Applying these annual expansion factors to national-level data, we estimate that the incidence of confirmed pediatric dengue throughout Nicaragua ranged from 300 to 1000 cases per 100,000 persons. We have estimated a much higher incidence of dengue than reported by the Ministry of Health. A country-specific expansion factor for dengue that allows for a more accurate estimate of incidence may aid governments and other institutions calculating disease burden, costs, resource needs for prevention and treatment, and the economic benefits of drug and vaccine development.

  19. Development and characteristics of the HANARO ex-core neutron irradiation facility for applications in the boron neutron capture therapy field

    CERN Document Server

    Kim, M S; Jun, B J; Kim, H; Lee, B C; Hwang, Sung-Yul; Jun, Byung-Jin; Kim, Heonil; Kim, Myong-Seop; Lee, Byung-Chul

    2006-01-01

    The HANARO ex-core neutron irradiation facility was developed for various applications in the boron neutron capture therapy (BNCT) field, and its characteristics have been investigated. In order to obtain a sufficient thermal neutron flux with a low level contamination of fast neutrons and gamma-rays, a radiation filtering method is adopted. The radiation filter has been designed by using a silicon single crystal cooled by liquid nitrogen and a bismuth crystal. The installation of the main components of the irradiation facility and the irradiation room are finished. Experimental measurements of the neutron beam characteristics have been performed by using bare and cadmium covered gold foils and wires. The in-phantom neutron flux distribution was measured for a flux mapping inside the phantom. The gamma-ray dose was determined by using TLD-700 thermoluminescence dosimeters. The thermal and fast neutron fluxes and the gamma-ray dose were calculated by using the MCNP code, and they were compared with experimenta...

  20. Design of a rotating facility for extracorporal treatment of an explanted liver with disseminated metastases by boron neutron capture therapy with an epithermal neutron beam.

    Science.gov (United States)

    Nievaart, V A; Moss, R L; Kloosterman, J L; van der Hagen, T H J J; van Dam, H; Wittig, A; Malago, M; Sauerwein, W

    2006-07-01

    In 2001, at the TRIGA reactor of the University of Pavia (Italy), a patient suffering from diffuse liver metastases from an adenocarcinoma of the sigmoid was successfully treated by boron neutron capture therapy (BNCT). The procedure involved boron infusion prior to hepatectomy, irradiation of the explanted liver at the thermal column of the reactor, and subsequent reimplantation. A complete response was observed. This encouraging outcome stimulated the Essen/Petten BNCT group to investigate whether such an extracorporal irradiation could be performed at the BNCT irradiation facility at the HFR Petten (The Netherlands), which has very different irradiation characteristics than the Pavia facility. A computational study has been carried out. A rotating PMMA container with a liver, surrounded by PMMA and graphite, is simulated using the Monte Carlo code MCNP. Due to the rotation and neutron moderation of the PMMA container, the initial epithermal neutron beam provides a nearly homogeneous thermal neutron field in the liver. The main conditions for treatment as reported from the Pavia experiment, i.e. a thermal neutron fluence of 4 x 10(12) +/- 20% cm(-2), can be closely met at the HFR in an acceptable time, which, depending on the defined conditions, is between 140 and 180 min.

  1. The medical-irradiation characteristics for neutron capture therapy at the Heavy Water Neutron Irradiation Facility of Kyoto University Research Reactor.

    Science.gov (United States)

    Sakurai, Yoshinori; Kobayashi, Tooru

    2002-10-01

    At the Heavy Water Neutron Irradiation Facility of the Kyoto University Research Reactor, the mix irradiation of thermal and epi-thermal neutrons, and the solo irradiation of epi-thermal neutrons are available additionally to the thermal neutron irradiation, and then the neutron capture therapy (NCT) at this facility became more flexible, after the update in 1996. The estimation of the depth dose distributions in NCT clinical irradiation, were performed for the standard irradiation modes of thermal, mixed and epi-thermal neutrons, from the both sides of experiment and calculation. On the assumption that the 10B concentration in tumor part was 40 ppm and the ratio of tumor to normal tissue was 3.5, the advantage depth were estimated to 5.4, 6.0, and 8.0, for the respective standard irradiation modes. It was confirmed that the various irradiation conditions can be selected according to the target-volume conditions, such as size, depth, etc. Besides, in the viewpoint of the radiation shielding for patient, it was confirmed that the whole-body exposure is effectively reduced by the new clinical collimators, compared with the old one.

  2. Demonstration of a high-intensity neutron source based on a liquid-lithium target for Accelerator based Boron Neutron Capture Therapy.

    Science.gov (United States)

    Halfon, S; Arenshtam, A; Kijel, D; Paul, M; Weissman, L; Berkovits, D; Eliyahu, I; Feinberg, G; Kreisel, A; Mardor, I; Shimel, G; Shor, A; Silverman, I; Tessler, M

    2015-12-01

    A free surface liquid-lithium jet target is operating routinely at Soreq Applied Research Accelerator Facility (SARAF), bombarded with a ~1.91 MeV, ~1.2 mA continuous-wave narrow proton beam. The experiments demonstrate the liquid lithium target (LiLiT) capability to constitute an intense source of epithermal neutrons, for Accelerator based Boron Neutron Capture Therapy (BNCT). The target dissipates extremely high ion beam power densities (>3 kW/cm(2), >0.5 MW/cm(3)) for long periods of time, while maintaining stable conditions and localized residual activity. LiLiT generates ~3×10(10) n/s, which is more than one order of magnitude larger than conventional (7)Li(p,n)-based near threshold neutron sources. A shield and moderator assembly for BNCT, with LiLiT irradiated with protons at 1.91 MeV, was designed based on Monte Carlo (MCNP) simulations of BNCT-doses produced in a phantom. According to these simulations it was found that a ~15 mA near threshold proton current will apply the therapeutic doses in ~1h treatment duration. According to our present results, such high current beams can be dissipated in a liquid-lithium target, hence the target design is readily applicable for accelerator-based BNCT.

  3. Five Years of Deferasirox Therapy for Cardiac Iron in β-Thalassemia Major.

    Science.gov (United States)

    Vlachaki, Efthymia; Agapidou, Alexandra; Spanos, Georgios; Klonizakis, Philippos; Vetsiou, Evaggelia; Mavroudi, Melahrini; Boura, Panagiota

    2015-01-01

    Myocardial siderosis in β-thalassemia major (β-TM) remains the leading cause of death. Deferasirox (DFX), a new iron chelation treatment, has proved to be effective in reducing or preventing cardiac iron burden in thalassemic patients according to clinical trials with maximum duration of up to 3 years except one that was recently published and lasted 5 years. The aim of this study was to evaluate the efficacy of DFX in reducing or preventing cardiac iron burden in 23 patients with β-TM after 5 years of therapy. All patients had a magnetic resonance imaging (MRI) T2* evaluation of their cardiac iron load before starting DFX therapy and after a period of 5 years. Ferritin levels and left ventricular ejection fraction (LVEF) were also evaluated at the same time. Deferasirox was administered in a starting dose of 30 mg/kg/day and never increased to more than 40 mg/kg/day. The MRI T2* cardiac iron load mean values before DFX was 32.82 ± 10.86 ms, and after 32.13 ± 7.74 ms, showing a stability in MRI T2* myocardial value but a significant improvement in two patients with an intermediate iron load (12 vs. 23 ms). The mean LVEF value was 68.43 ± 7.08% before treatment with DFX and 67.95 ± 5.94% after DFX therapy without significant change. Our results confirm previous studies that DFX is considered an effective chelating agent used as monotherapy for at least 5 years and is more efficacious in moderate to severe cardiac iron loaded thalassemic patients.

  4. Case Study: Manual Therapy in Patient of 18 Years with Youthful Scoliosis Idiopathic Summary

    Directory of Open Access Journals (Sweden)

    Claudia Yaneth Franco Monsalve

    2007-12-01

    Full Text Available Scoliosis is a lateral deviation of the spine from the mean line, characterized by a lateral curvature and a vertebral rotation. It is generallyof idiopathic character and appears mainly in adolescent females. Multiple techniques of conservative treatment for the scoliosis exist such as the manual therapy that complements the treatment for this pathology. This technique uses manipulation of soft tissue and bone, obtainingtherefore a more effective recovery, improving the quality of life of the patient. The objective of this study of case was to compareand to describe the changes in the conditionsof an eighteen years old patient, with left thoracolumbar scoliosis by the application of manual therapy; integral valuation was carried out by manual therapy, orthopedic, computerizedposition analysis, analyses the place of job, treatments with physical instruments, mobilizationsof the thoracic and lumbar joints (segmentsT5-T6, T6-T7, T7-T8, T8-T9, muscular energy techniques, exercises of global postural re-education, cervical and lumbar stabilization, exercises of fortification for weak musculature and stretching exercises to elongate retracted musculature. At the beginning of the treatment, the angle of Cobb was 24º ,verified through ax-ray, and after the sessions of manual therapy it was 18º, demonstrating significantly improved angle (6º. The effectiveness of the treatment was verified: diminution of the pain, increase of the muscular force, postural realignment, the satisfactionof the patient and significant recovery confirmed by the radiographic studies.

  5. Deep drilling of ancient Lake Ohrid (Balkan region) to capture over 1 million years of evolution and global climate cycling

    Science.gov (United States)

    Wagner, Bernd; Francke, Alexander; Wilke, Thomas; Krastel, Sebastian; Zanchetta, Giovanni; Sulpizio, Roberto; Reicherter, Klaus; Leng, Melanie; Grazhdani, Andon; Trajanovski, Sasho; Levkov, Zlatko; Reed, Jane; Wonik, Thomas

    2014-05-01

    Ancient lakes, with sediment records spanning >1 million years, are very rare. The UNESCO World Heritage site of Lake Ohrid in the Balkan region is thought to be the oldest lake in continuous existence in Europe and, with 212 endemic species described to date, is a hotspot of evolution. An international group of scientists working on a project entitled 'Scientific Collaboration on Past Speciation Conditions in Lake Ohrid (SCOPSCO)' realized a deep drilling campaign of Lake Ohrid in spring 2013. Based on several coring seismic campaigns between 2004 and 2011, Lake Ohrid became the target of an ICDP deep drilling campaign, with specific research aims: (i) obtain precise information about the age and origin of the lake, (ii) unravel the lake's seismotectonic history, (iii) obtain a continuous record of Quaternary volcanic activity and climate change, and (iv) investigate the influence of major geological/environmental events on evolution and the generation of extraordinary endemic biodiversity. Drilling began in April 2013 using the Deep Lake Drilling System (DLDS) of DOSECC (USA). The campaign, completed by late May, was deemed one of the most successful ICDP lake drilling projects, with a total of ~2100 m of sediment recovered from four different sites. At the central "DEEP" site, hydro-acoustic data indicated a maximum sediment fill of ca. 700 m, of which the uppermost 568 m was recovered. Coarse gravel and pebbles underlying clay and shallow water facies hampered deeper penetration. A total of 1526 m of sediment cores was collected from six boreholes, with a composite field recovery ('master core') of 544 m (95%). Three additional sites were drilled in order to analyze lake-level fluctuations, catchment dynamics, biodiversity and evolution processes ("Cerava", deepest drilled depth: 90 m), to investigate active tectonics and spring dynamics ("Gradiste", deepest drilled depth: 123 m), and to try to understand the geological origins of the Ohrid Basin ("Pestani

  6. Capture ready study

    Energy Technology Data Exchange (ETDEWEB)

    Minchener, A.

    2007-07-15

    There are a large number of ways in which the capture of carbon as carbon dioxide (CO{sub 2}) can be integrated into fossil fuel power stations, most being applicable for both gas and coal feedstocks. To add to the choice of technology is the question of whether an existing plant should be retrofitted for capture, or whether it is more attractive to build totally new. This miscellany of choices adds considerably to the commercial risk of investing in a large power station. An intermediate stage between the non-capture and full capture state would be advantageous in helping to determine the best way forward and hence reduce those risks. In recent years the term 'carbon capture ready' or 'capture ready' has been coined to describe such an intermediate stage plant and is now widely used. However a detailed and all-encompassing definition of this term has never been published. All fossil fuel consuming plant produce a carbon dioxide gas byproduct. There is a possibility of scrubbing it with an appropriate CO{sub 2} solvent. Hence it could be said that all fossil fuel plant is in a condition for removal of its CO{sub 2} effluent and therefore already in a 'capture ready' state. Evidently, the practical reality of solvent scrubbing could cost more than the rewards offered by such as the ETS (European Trading Scheme). In which case, it can be said that although the possibility exists of capturing CO{sub 2}, it is not a commercially viable option and therefore the plant could not be described as ready for CO{sub 2} capture. The boundary between a capture ready and a non-capture ready condition using this definition cannot be determined in an objective and therefore universally acceptable way and criteria must be found which are less onerous and less potentially contentious to assess. 16 refs., 2 annexes.

  7. Occupational therapy and the journal citation reports: 10-year performance trajectories.

    Science.gov (United States)

    Holguin, Jess Anthony

    2009-01-01

    The purpose of this study was to document performance of occupational therapy journals on the metrics of the Journal Citation Reports (JCR), the annually appearing index used as a yardstick to assess the quality of scholarly publications. Outcomes for the field's two indexed journals, the American Journal of Occupational Therapy and OTJR: Occupation, Participation and Health, were assessed over a 10-year period (1996-2005) to determine their overall standing and patterns of change on each of the JCR's five metrics. The mean category ranking for the two journals was generally above the 50th percentile. However, they performed least adequately and evidenced a downward trend over time on the most widely used metric (the journal impact factor). Possible reasons underlying this latter result are explored, pressing implications of the overall findings for practice and research are discussed, and strategic steps toward ethically safeguarding the profession's viability are offered.

  8. Monte-Carlo simulation of primary stochastic effects induced at the cellular level in boron neutron capture therapy; Simulation Monte-Carlo des effets stochastiques primaires induits au niveau cellulaire lors de la therapie par capture de neutrons sur le {sup 10}B

    Energy Technology Data Exchange (ETDEWEB)

    Cirioni, L.; Patau, J.P.; Nepveu, F. [Universite Paul Sabatier, 31 - Toulouse (France)

    1998-04-01

    A Monte Carlo code is developed to study the action of particles in Boron Neutron Capture Therapy (BNCT). Our aim is to calculate the probability of dissipating a lethal dose in cell nuclei. Cytoplasmic and nuclear membranes are considered as non-concentric ellipsoids. All geometrical parameters may be adjusted to fit actual configurations. The reactions {sup 10}B(n,{gamma} {alpha}){sup 7}Li and {sup 14}N(n,p) {sup 14}C create heavy ions which slow clown losing their energy. Their trajectories can be simulated taking into account path length straggling. The contribution of each reaction to the deposited dose in different cellular compartments can be studied and analysed for any distribution of {sup 10}B. (authors)

  9. Sitagliptin in type 2 diabetes mellitus: Efficacy after five years of therapy.

    Science.gov (United States)

    Derosa, Giuseppe; D'Angelo, Angela; Maffioli, Pamela

    2015-10-01

    The aim of this study was to investigate whether the positive effects of sitagliptin were maintained even after five years of treatment. Starting from 2008 to today, we treated 624 patients, not well controlled by current therapy, with the addition of sitagliptin 100 mg/die. Patients included 216 subjects treated with metformin, 206 treated with sulfonylureas, and 202 treated with pioglitazone. Sitagliptin was added to metformin, sulfonylureas and pioglitazone in monotherapy, respectively, and the data were compared with those of 620 patients treated with sulfonylureas+metformin, pioglitazone+metformin and pioglitazone+sulfonylureas matched for age, sex, diabetes duration. We recorded that the addition of sitagliptin to current hypoglycemic therapy led to a reduction of HbA1c similar to that obtained with sulfonylureas after two years. After five years of treatment, changes in HbA1c suggest a better glycemic control over the long term with sitagliptin compared to other treatments, particularly when compared with sulfonylureas. The other parameters evaluated as fasting plasma glucose, post-prandial plasma glucose and insulin levels, confirm the trends observed for the value of HbA1c. Regarding BMI, it increased with sulfonylureas and pioglitazone compared to sitagliptin. Patients treated with sulfonylureas had a higher incidence of hypoglycemia compared to sitagliptin. In conclusion, sitagliptin seems to maintain its positive effects on glycemia and fasting plasma insulin on the long term.

  10. Structural but not functional neuroplasticity one year after effective cognitive behaviour therapy for social anxiety disorder

    DEFF Research Database (Denmark)

    Månsson, Kristoffer N T; Salami, Alireza; Carlbring, Per

    2017-01-01

    Effective psychiatric treatments ameliorate excessive anxiety and induce neuroplasticity immediately after the intervention, indicating that emotional components in the human brain are rapidly adaptable. Still, the interplay between structural and functional neuroplasticity is poorly understood......, and studies of treatment-induced long-term neuroplasticity are rare. Functional and structural magnetic resonance imaging (using 3T MRI) was performed in 13 subjects with social anxiety disorder on 3 occasions over 1year. All subjects underwent 9 weeks of Internet-delivered cognitive behaviour therapy...

  11. Two-year results after convective radiofrequency water vapor thermal therapy of symptomatic benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Dixon CM

    2016-11-01

    Full Text Available Christopher M Dixon,1 Edwin Rijo Cedano,2 Dalibor Pacik,3 Vítězslav Vit,3 Gabriel Varga,3 Lennart Wagrell,4 Thayne R Larson,5 Lance A Mynderse6 1Department of Urology, Phelps Memorial Hospital, Sleepy Hollow, New York, NY, USA; 2Department of Urology, Clinical Canela, La Romana, Dominican Republic; 3Department of Urology, Brno University Hospital, Brno, Czech Republic; 4Urologcentrum, Stockholm, Sweden; 5Institute of Medical Research, Scottsdale, AZ, 6Department of Urology, Mayo Clinic, Rochester, MN, USA Objective: The objective of this study was to assess the effectiveness and safety of convective radiofrequency (RF water vapor thermal therapy in men with lower urinary tract symptoms (LUTS associated with benign prostatic hyperplasia (BPH; a pilot study design with 2-year follow-up evaluations.Patients and methods: Men aged ≥45 years with an International Prostate Symptom Score ≥13, a maximum urinary flow rate (Qmax ≤15 mL/s, and prostate volume 20–120 cc were enrolled in a prospective, open-label pilot study using convective RF water vapor energy with the Rezūm System. Patients were followed up for 2 years after transurethral thermal treatment at 3 international centers in the Dominican Republic, Czech Republic, and Sweden. The transurethral thermal therapy utilizes radiofrequency to generate wet thermal energy in the form of water vapor injected through a rigid endoscope into the lateral lobes and median lobe as needed. Urinary symptom relief, urinary flow, quality of life (QOL impact, sexual function, and adverse events (AEs were assessed at 1 week, 1, 3, 6, 12, and 24 months. Results: LUTS, flow rate, and QOL showed significant improvements from baseline; prostate volumes were appreciably reduced. Sexual function was maintained and no de novo erectile dysfunction occurred. The responses evident as early as 1 month after treatment remained consistent and durable over the 24 months of study. Early AEs were typically transient and

  12. Hyperparathyroidism Two Years after Radioactive Iodine Therapy in an Adolescent Male

    Directory of Open Access Journals (Sweden)

    Danielle L. Gomez

    2014-01-01

    Full Text Available Primary hyperparathyroidism is a very rare complication following radioactive iodine therapy. There is typically a latency period of more than a decade following radiation exposure and, therefore, it is observed almost exclusively in adults. Consequently, pediatricians are not aware of the association. We present a case of primary hyperparathyroidism due to a solitary parathyroid adenoma occurring in an adolescent male two years following radioactive iodine treatment for papillary thyroid carcinoma. Periodic screening of serum calcium following ablative doses of radioactive iodine for thyroid cancer may be justified even in adolescents.

  13. A CONCEPTUAL DESIGN OF NEUTRON COLLIMATOR IN THE THERMAL COLUMN OF KARTINI RESEARCH REACTOR FOR IN VITRO AND IN VIVO TEST OF BORON NEUTRON CAPTURE THERAPY

    Directory of Open Access Journals (Sweden)

    Nina Fauziah

    2015-03-01

    Full Text Available Studies were carried out to design a collimator which results in epithermal neutron beam for IN VITRO and IN VIVO of Boron Neutron Capture Therapy (BNCT at the Kartini research reactor by means of Monte Carlo N-Particle (MCNP codes. Reactor within 100 kW of thermal power was used as the neutron source. The design criteria were based on recommendation from the International Atomic Energy Agency (IAEA. All materials used were varied in size, according to the value of mean free path for each material. MCNP simulations indicated that by using 5 cm thick of Ni as collimator wall, 60 cm thick of Al as moderator, 15 cm thick of 60Ni as filter, 2 cm thick of Bi as γ-ray shielding, 3 cm thick of 6Li2CO3-polyethylene as beam delimiter, with 1 to 5 cm varied aperture size, epithermal neutron beam with maximum flux of 7.65 x 108 n.cm-2.s-1 could be produced. The beam has minimum fast neutron and γ-ray components of, respectively, 1.76 x 10-13 Gy.cm2.n-1 and 1.32 x 10-13 Gy.cm2.n-1, minimum thermal neutron per epithermal neutron ratio of 0.008, and maximum directionality of 0.73. It did not fully pass the IAEA’s criteria, since the epithermal neutron flux was below the recommended value, 1.0 x 109 n.cm-2.s-1. Nonetheless, it was still usable with epithermal neutron flux exceeding 5.0 x 108 n.cm-2.s-1. When it was assumed that the graphite inside the thermal column was not discharged but only the part which was going to be replaced by the collimator, the performance of the collimator became better within the positive effect from the surrounding graphite that the beam resulted passed all criteria with epithermal neutron flux up to 1.68 x 109 n.cm-2.s-1. Keywords: design, collimator, epithermal neutron beam, BNCT, MCNP, criteria   Telah dilakukan penelitian tentang desain kolimator yang menghasilkan radiasi netron epitermal untuk uji in vitro dan in vivo pada Boron Neutron Capture Therapy (BNCT di Reaktor Riset Kartini dengan menggunakan program Monte

  14. Epidemiologic trends in chronic renal replacement therapy over forty years: A Swiss dialysis experience

    Directory of Open Access Journals (Sweden)

    Lehmann Petra

    2012-07-01

    Full Text Available Abstract Background Long term longitudinal data are scarce on epidemiological characteristics and patient outcomes in patients on maintenance dialysis, especially in Switzerland. We examined changes in epidemiology of patients undergoing renal replacement therapy by either hemodialysis or peritoneal dialysis over four decades. Methods Single center retrospective study including all patients which initiated dialysis treatment for ESRD between 1970 and 2008. Analyses were performed for subgroups according to dialysis vintage, based on stratification into quartiles of date of first treatment. A multivariate model predicting death and survival time, using time-dependent Cox regression, was developed. Results 964 patients were investigated. Incident mean age progressively increased from 48 ± 14 to 64 ± 15 years from 1st to 4th quartile (p  Discussion We document an increase of a predominantly elderly incident and prevalent dialysis population, with progressively shortened survival after initiation of renal replacement over four decades, and, nevertheless, a prolonged lifespan. Analysis of the data is limited by lack of information on comorbidity in the study population. Conclusions Survival in patients on renal replacement therapy seems to be affected not only by medical and technical advances in dialysis therapy, but may mostly reflect progressively lower mortality of individuals with cardiovascular and metabolic complications, as well as a policy of accepting older and polymorbid patients for dialysis in more recent times. This is relevant to make demographic predictions in face of the ESRD epidemic nephrologists and policy makers are facing in industrialized countries.

  15. 12-Year within-wound study of the effectiveness of custom pressure garment therapy.

    Science.gov (United States)

    Engrav, L H; Heimbach, D M; Rivara, F P; Moore, M L; Wang, J; Carrougher, G J; Costa, B; Numhom, S; Calderon, J; Gibran, N S

    2010-11-01

    Pressure garment therapy is standard of care for prevention and treatment of hypertrophic scarring after burn injury. Nevertheless there is little objective data that confirms effectiveness. The purpose of this study was to determine the effectiveness of pressure garment therapy with objective data obtained with a randomized within-wound comparison. We enrolled consecutive patients with forearm injuries over a 12-year period. The subjects wore custom garments with normal and low compression randomized to either the proximal or distal zones. Hardness, color and thickness of wounds were objectively measured using appropriate devices; clinical appearance was measured by a panel masked to the identity of the pressure treated area. Wounds treated with normal compression were significantly softer, thinner, and had improved clinical appearance. There was no interaction of any effect with patient ethnicity. However, these findings were clinically evident only with moderate to severe scarring. We conclude that pressure garment therapy is effective, but that the clinical benefit is restricted to those patients with moderate or severe scarring.

  16. Irradiation facility for boron neutron capture therapy application based on a rf-driven D-T neutron source and a new beam shaping assembly (abstract)

    Science.gov (United States)

    Cerullo, N.; Esposito, J.; Leung, K. N.

    2002-02-01

    Selecting the best neutron source for boron neutron capture therapy (BNCT) requires optimizing neutron beam parameters. This involves solving many complex problems. Safety issues related to the use of nuclear reactor in hospital environments, as well as lower costs have led to interest in the development of accelerator-driven neutron sources. The BNCT research programs at the Nuclear Departments of Pisa and Genova Universities (DIMNP and DITEC) focus on studies of new concepts for accelerator-based DT neutron sources. Simple and compact accelerator designs using relatively low deuteron beam energy, ˜100 keV, have been developed which, in turn, can generate high neutron yields. New studies have been started for optimization of moderator materials for the 14.1 MeV DT neutrons. Our aim is to obtain an epithermal neutron beam for therapeutic application at the exit end, with minimal beam intensity losses, the specific goal is to achieve an epithermal neutron flux of at least of 1×109 n/cm2 s at the beam port, with low gamma and fast neutron dose contamination. According to the most recent neutron BNCT beam parameters some moderating and spectrum shifter materials and geometrical configurations have thus far been tested, and neutron and gamma beam data at beam port have been computed. A possible beam shaping assembly model has been designed. This research demonstrates that a DT neutron source could be successfully implemented for BNCT application, with performance surpassing the minimum requirements stated above, using DT neutron sources with yields in the range 1013-1014 n/s. The latest Monte Carlo simulation results of an accelerator based facility which relies on a rf-driven DT fusion neutron generator will be presented.

  17. Improvement of the boron neutron capture therapy (BNCT) by the previous administration of the histone deacetylase inhibitor sodium butyrate for the treatment of thyroid carcinoma.

    Science.gov (United States)

    Perona, M; Rodríguez, C; Carpano, M; Thomasz, L; Nievas, S; Olivera, M; Thorp, S; Curotto, P; Pozzi, E; Kahl, S; Pisarev, M; Juvenal, G; Dagrosa, A

    2013-08-01

    We have shown that boron neutron capture therapy (BNCT) could be an alternative for the treatment of poorly differentiated thyroid carcinoma (PDTC). Histone deacetylase inhibitors (HDACI) like sodium butyrate (NaB) cause hyperacetylation of histone proteins and show capacity to increase the gamma irradiation effect. The purpose of these studies was to investigate the use of the NaB as a radiosensitizer of the BNCT for PDTC. Follicular thyroid carcinoma cells (WRO) and rat thyroid epithelial cells (FRTL-5) were incubated with 1 mM NaB and then treated with boronophenylalanine ¹⁰BPA (10 μg ¹⁰B ml⁻¹) + neutrons, or with 2, 4-bis (α,β-dihydroxyethyl)-deutero-porphyrin IX ¹⁰BOPP (10 μg ¹⁰B ml⁻¹) + neutrons, or with a neutron beam alone. The cells were irradiated in the thermal column facility of the RA-3 reactor (flux = (1.0 ± 0.1) × 10¹⁰ n cm⁻² s⁻¹). Cell survival decreased as a function of the physical absorbed dose in both cell lines. Moreover, the addition of NaB decreased cell survival (p < 0.05) in WRO cells incubated with both boron compounds. NaB increased the percentage of necrotic and apoptotic cells in both BNCT groups (p < 0.05). An accumulation of cells in G2/M phase at 24 h was observed for all the irradiated groups and the addition of NaB increased this percentage. Biodistribution studies of BPA (350 mg kg⁻¹ body weight) 24 h after NaB injection were performed. The in vivo studies showed that NaB treatment increases the amount of boron in the tumor at 2-h post-BPA injection (p < 0.01). We conclude that NaB could be used as a radiosensitizer for the treatment of thyroid carcinoma by BNCT.

  18. Dosimetry and radiobiology at the new RA-3 reactor boron neutron capture therapy (BNCT) facility: application to the treatment of experimental oral cancer.

    Science.gov (United States)

    Pozzi, E; Nigg, D W; Miller, M; Thorp, S I; Heber, E M; Zarza, L; Estryk, G; Monti Hughes, A; Molinari, A J; Garabalino, M; Itoiz, M E; Aromando, R F; Quintana, J; Trivillin, V A; Schwint, A E

    2009-07-01

    The National Atomic Energy Commission of Argentina (CNEA) constructed a novel thermal neutron source for use in boron neutron capture therapy (BNCT) applications at the RA-3 research reactor facility located in Buenos Aires. The aim of the present study was to perform a dosimetric characterization of the facility and undertake radiobiological studies of BNCT in an experimental model of oral cancer in the hamster cheek pouch. The free-field thermal flux was 7.1 x 10(9) n cm(-2)s(-1) and the fast neutron flux was 2.5 x 10(6) n cm(-2)s(-1), indicating a very well-thermalized neutron field with negligible fast neutron dose. For radiobiological studies it was necessary to shield the body of the hamster from the neutron flux while exposing the everted cheek pouch bearing the tumors. To that end we developed a lithium (enriched to 95% in (6)Li) carbonate enclosure. Groups of tumor-bearing hamsters were submitted to BPA-BNCT, GB-10-BNCT, (GB-10+BPA)-BNCT or beam only treatments. Normal (non-cancerized) hamsters were treated similarly to evaluate normal tissue radiotoxicity. The total physical dose delivered to tumor with the BNCT treatments ranged from 6 to 8.5 Gy. Tumor control at 30 days ranged from 73% to 85%, with no normal tissue radiotoxicity. Significant but reversible mucositis in precancerous tissue surrounding tumors was associated to BPA-BNCT. The therapeutic success of different BNCT protocols in treating experimental oral cancer at this novel facility was unequivocally demonstrated.

  19. Effects of employing a 10B-carrier and manipulating intratumour hypoxia on local tumour response and lung metastatic potential in boron neutron capture therapy

    Science.gov (United States)

    Masunaga, S; Sakurai, Y; Tanaka, H; Suzuki, M; Liu, Y; Kondo, N; Maruhashi, A; Kinashi, Y; Ono, K

    2012-01-01

    Objectives To evaluate the effects of employing a 10B-carrier and manipulating intratumour hypoxia on local tumour response and lung metastatic potential in boron neutron capture therapy (BNCT) by measuring the response of intratumour quiescent (Q) cells. Methods B16-BL6 melanoma tumour-bearing C57BL/6 mice were continuously given 5-bromo-2′-deoxyuridine (BrdU) to label all proliferating (P) cells. The tumours received reactor thermal neutron beam irradiation following the administration of a 10B-carrier [L-para-boronophenylalanine-10B (BPA) or sodium mercaptoundecahydrododecaborate-10B (BSH)] in combination with an acute hypoxia-releasing agent (nicotinamide) or mild temperature hyperthermia (MTH). Immediately after the irradiation, cells from some tumours were isolated and incubated with a cytokinesis blocker. The responses of the Q and total (P+Q) cell populations were assessed based on the frequency of micronuclei using immunofluorescence staining for BrdU. In other tumour-bearing mice, macroscopic lung metastases were enumerated 17 days after irradiation. Results BPA-BNCT increased the sensitivity of the total tumour cell population more than BSH-BNCT. However, the sensitivity of Q cells treated with BPA was lower than that of BSH-treated Q cells. With or without a 10B–carrier, MTH enhanced the sensitivity of the Q cell population. Without irradiation, nicotinamide treatment decreased the number of lung metastases. With irradiation, BPA-BNCT, especially in combination with nicotinamide treatment, showed the potential to reduce the number of metastases more than BSH-BNCT. Conclusion BSH-BNCT in combination with MTH improves local tumour control, while BPA-BNCT in combination with nicotinamide may reduce the number of lung metastases. PMID:22391496

  20. Therapeutic efficacy of boron neutron capture therapy mediated by boron-rich liposomes for oral cancer in the hamster cheek pouch model.

    Science.gov (United States)

    Heber, Elisa M; Hawthorne, M Frederick; Kueffer, Peter J; Garabalino, Marcela A; Thorp, Silvia I; Pozzi, Emiliano C C; Monti Hughes, Andrea; Maitz, Charles A; Jalisatgi, Satish S; Nigg, David W; Curotto, Paula; Trivillin, Verónica A; Schwint, Amanda E

    2014-11-11

    The application of boron neutron capture therapy (BNCT) mediated by liposomes containing (10)B-enriched polyhedral borane and carborane derivatives for the treatment of head and neck cancer in the hamster cheek pouch oral cancer model is presented. These liposomes are composed of an equimolar ratio of cholesterol and 1,2-distearoyl-sn-glycero-3-phosphocholine, incorporating K[nido-7-CH3(CH2)15-7,8-C2B9H11] (MAC) in the bilayer membrane while encapsulating the hydrophilic species Na3[ae-B20H17NH3] (TAC) in the aqueous core. Unilamellar liposomes with a mean diameter of 83 nm were administered i.v. in hamsters. After 48 h, the boron concentration in tumors was 67 ± 16 ppm whereas the precancerous tissue contained 11 ± 6 ppm, and the tumor/normal pouch tissue boron concentration ratio was 10:1. Neutron irradiation giving a 5-Gy dose to precancerous tissue (corresponding to 21 Gy in tumor) resulted in an overall tumor response (OR) of 70% after a 4-wk posttreatment period. In contrast, the beam-only protocol gave an OR rate of only 28%. Once-repeated BNCT treatment with readministration of liposomes at an interval of 4, 6, or 8 wk resulted in OR rates of 70-88%, of which the complete response ranged from 37% to 52%. Because of the good therapeutic outcome, it was possible to extend the follow-up of BNCT treatment groups to 16 wk after the first treatment. No radiotoxicity to normal tissue was observed. A salient advantage of these liposomes was that only mild mucositis was observed in dose-limiting precancerous tissue with a sustained tumor response of 70-88%.

  1. One-year evaluation of the effect of physical therapy for masticatory muscle pain : A randomized controlled trial

    NARCIS (Netherlands)

    Craane, B.; Dijkstra, P. U.; Stappaerts, K.; De Laat, A.

    2012-01-01

    Physical therapy is widely used to decrease pain and restore function in patients suffering from masticatory muscle pain. Controlled studies on its efficacy are scarce. This study evaluated the 1-year effect of a 6-week physical therapy programme in a single blind, randomized, controlled trial. Fift

  2. [Correction of psychophysical development of preschool children 3-4 year old with movement disorders by means of Bobath therapy

    OpenAIRE

    Bukhovets, B. O.

    2016-01-01

    This study deals with the definition of efficiency application means Bobath therapy as main correction psychophysical development method of preschool age 3 -4 years children, who have movement disorders.

  3. Bone mineral density in rheumatoid arthritis patients 1 year after adalimumab therapy: arrest of bone loss

    Science.gov (United States)

    Wijbrandts, C A; Klaasen, R; Dijkgraaf, M G W; Gerlag, D M; van Eck-Smit, B L F; Tak, P P

    2009-01-01

    Objective: To explore the effects of anti-tumour necrosis factor (TNF)α antibody therapy on bone mineral density (BMD) of the lumbar spine and femur neck in patients with rheumatoid arthritis (RA). Methods: A total of 50 patients with active RA (DAS28⩾3.2) who started adalimumab (40 mg subcutaneously/2 weeks) were included in an open label prospective study. All patients used stable methotrexate and were allowed to use prednisone (⩽10 mg/day). The BMD of the lumbar spine and femur neck was measured before and 1 year after start of treatment. Results: Disease activity at baseline (28-joint Disease Activity Score (DAS28)) and disease duration were inversely correlated with femoral neck BMD and lumbar spine BMD (p<0.05). Mean BMD of lumbar spine and femur neck remained unchanged after 1 year of adalimumab therapy (+0.3% and +0.3%, respectively). Of interest, a beneficial effect of prednisone on change in femur neck BMD was observed with a relative increase with prednisone use (+2.5%) compared to no concomitant prednisone use (−0.7%), (p = 0.015). Conclusion: In contrast to the progressive bone loss observed after conventional disease-modifying antirheumatic drug therapy, TNF blockade may result in an arrest of general bone loss. Consistent with previous observations, the data also suggest that the net effect of low-dose corticosteroids on BMD in RA may be beneficial, possibly resulting from their anti-inflammatory effects. PMID:18408246

  4. Experiences of internet-delivered cognitive behavior therapy for social anxiety disorder four years later: A qualitative study

    Directory of Open Access Journals (Sweden)

    Camilla Olsson Halmetoja

    2014-07-01

    Full Text Available The current study is a qualitative follow-up of a study on guided internet-delivered cognitive behavior therapy (ICBT for social anxiety disorder (SAD, conducted four years after treatment completion. The main aim was to capture participants' description of their experiences of the treatment, their view on treatment effects, memories of the treatment, and whether they continued using the gained knowledge after treatment. Sixty participants were selected from the original study's treatment group. A criterion based sampling approach was used based on the obtained treatment effect, and with a minimum of five completed treatment modules. E-mail invitations were sent, with information about the follow-up and the instruction to respond if interested in participating. Twelve semi-structured interviews were made and the material was analyzed using an approach based on grounded theory. The results showed that all participants found the treatment to have some effect, but they also found it to be demanding, difficult, and hard. Many appreciated to hear of the experiences of other participants in the online forum. Under the theme of memory, most could describe the setup of the treatment in general terms. The exposure module was mentioned by all, cognitive restructuring by most, and some also reported memories of the psychoeducation. A core process was identified which involved how the attained treatment effect was viewed over the time, and how this view changed from treatment completion to current time. The findings outlined in this study describe how treatment effects can be sustained via an active approach to the treatment and the symptoms of SAD.

  5. [Therapy of multiple myeloma. Study of hospital patients: 81 cases in 16 years' observation].

    Science.gov (United States)

    Monti, G; Cereda, U G; Pessina, E; De Micheli, N; Grisetti, G C; Invernizzi, F

    1983-02-11

    The results achieved with different approaches of chemotherapy protocols applied to 81 patients affected by multiple mieloma and followed up for a duration of 16 years in the geographical area pertaining to the Saronno County Hospital are presented. All the patients are divided into sub-groups, according to the type of treatment they required while being monitored over the years. Each single sub-group is evaluated according to the following criteria: objective response to therapy; median survival rates; toxic effects due to drug exposure. The results are analyzed with reference to the most relevant literature on the matter. A comprehensive retrospective review of emerging data suggests an overlapping median survival--30 and 31 months--in patients given monochemotherapy as such as in those given polychemotherapy. Evidence is also made for a clearly meaningful increase of survival in treated patients compared with that of untreated ones. Median survival depends significantly on the initial stage of the disease. Both therapeutical effectiveness and toxicity are shown to be higher, in accordance with the current literature, in polychemotherapy which include vincristine--especially when a large tumor cell mass is pointed out--compared with therapy based on alkilating agents and prednisone.

  6. Successfully breaking a 20-year cycle of hospitalizations with recovery-oriented cognitive therapy for schizophrenia.

    Science.gov (United States)

    Grant, Paul M; Reisweber, Jarrod; Luther, Lauren; Brinen, Aaron P; Beck, Aaron T

    2014-05-01

    Individuals with severe and persistent schizophrenia can present challenges (e.g., difficulties sustaining motivation and conducting information processing tasks) to the implementation of recovery-oriented care. We present a successful application of recovery-oriented cognitive therapy (CT-R), a fusion of the spirit and principles of the recovery movement with the evidence base and know-how of cognitive therapy, that helped an individual with schizophrenia move along her recovery path by overcoming specific obstacles, including a 20-year cycle of hospitalizations (five per year), daily phone calls to local authorities, threatening and berating "voices," the belief that she would be killed at any moment, and social isolation. Building on strengths, treatment included collaboratively identifying meaningful personal goals that were broken down into successfully accomplishable tasks (e.g., making coffee) that disconfirmed negative beliefs and replaced the phone calling. At the end of treatment and at a 6-month follow-up, the phone calls had ceased, psychosocial functioning and neurocognitive performance had increased, and avolition and positive symptoms had decreased. She was not hospitalized once in 24 months. Results suggest that individuals with schizophrenia have untapped potential for recovery that can be mobilized through individualized, goal-focused psychosocial interventions.

  7. Enzyme replacement therapy in late-onset Pompe's disease: a three-year follow-up.

    Science.gov (United States)

    Winkel, Léon P F; Van den Hout, Johanna M P; Kamphoven, Joep H J; Disseldorp, Janus A M; Remmerswaal, Maaike; Arts, Willem F M; Loonen, M Christa B; Vulto, Arnold G; Van Doorn, Pieter A; De Jong, Gerard; Hop, Wim; Smit, G Peter A; Shapira, Stuart K; Boer, Marijke A; van Diggelen, Otto P; Reuser, Arnold J J; Van der Ploeg, Ans T

    2004-04-01

    Pompe's disease is an autosomal recessive myopathy. The characteristic lysosomal storage of glycogen is caused by acid alpha-glucosidase deficiency. Patients with late-onset Pompe's disease present with progressive muscle weakness also affecting pulmonary function. In search of a treatment, we investigated the feasibility of enzyme replacement therapy with recombinant human alpha-glucosidase from rabbit milk. Three patients (aged 11, 16, and 32 years) were enrolled in the study. They were all wheelchair-bound and two of them were ventilator dependent with a history of deteriorating pulmonary function. After 3 years of treatment with weekly infusions of alpha-glucosidase, the patients had stabilized pulmonary function and reported less fatigue. The youngest and least affected patient showed an impressive improvement of skeletal muscle strength and function. After 72 weeks of treatment, he could walk without support and finally abandoned his wheelchair. Our findings demonstrate that recombinant human alpha-glucosidase from rabbit milk has a therapeutic effect in late-onset Pompe's disease. There is good reason to continue the development of enzyme replacement therapy for Pompe's disease and to explore further the production of human therapeutic proteins in the milk of mammals.

  8. Two-years therapy with bosentan of pulmonary arterial hypertension related to connective tissue diseases

    Directory of Open Access Journals (Sweden)

    M. Rizzo

    2011-09-01

    Full Text Available Objective: Pulmonary arterial hypertension (PAH is a rare but severe complication of connective tissue diseases (CTD, with a negative impact on patients survival. Bosentan, a receptor antagonist of endothelin, has been proved effective for the treatment of PAH. The aim of this study was to evaluate the effects and the safety of bosentan administered for 2 years in a group of patients with PAH related to CTD. Methods: Twelve patients with PAH related to systemic sclerosis (8 cases, SLE (2 cases, mixed connective tissue disease (1 case and polymyositis (1 case attending the Rheumatology Unit of Padova University were treated with bosentan for two years. Distance walked in 6 minutes, right ventricular systolic pressure and mean pulmonary artery pressure estimated by doppler echocardiography were evaluated at baseline and after 6, 12, 18 and 24 months of treatment. Safety was assessed by laboratory tests performed every two months. Results: During bosentan treatment, a significant decrease of right ventricular systolic pressure was observed after 6, 12, 18 and 24 months in comparison to baseline, whereas pulmonary artery mean pressure remained unchanged. Distance walked in 6 minutes slightly increased after 6 and 12 months, but significantly decreased after 18 and 24 months, mostly because complications of CTD which compromised the ability to walk arose in 4 patients. Adverse events related to bosentan were observed in 2 cases. Conclusions: Bosentan has been demonstrated effective in reducing pulmonary arterial pressure in a two-year period of treatment. Exercise capacity improved only in the first year of therapy and worsened thereafter, suggesting the opportunity of a combination therapy for a long-term treatment of PAH related to CTD.

  9. Phase II clinical study of boron neutron capture therapy combined with X-ray radiotherapy/temozolomide in patients with newly diagnosed glioblastoma multiforme-Study design and current status report

    Energy Technology Data Exchange (ETDEWEB)

    Kawabata, Shinji, E-mail: neu046@poh.osaka-med.ac.jp [Department of Neurosurgery, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka 569-8686 (Japan); Miyatake, Shin-Ichi; Hiramatsu, Ryo; Hirota, Yuki; Miyata, Shiro; Takekita, Yoko; Kuroiwa, Toshihiko [Department of Neurosurgery, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka 569-8686 (Japan); Kirihata, Mitsunori [Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-1 Gakuen-cho, Naka-ku, Sakai, Osaka 599-8931 (Japan); Sakurai, Yoshinori; Maruhashi, Akira; Ono, Koji [Kyoto University Research Reactor Institute, 2 Asashiro-Nishi, Kumatori-cho, Sennan-gun, Osaka 590-0494 (Japan)

    2011-12-15

    Recently, we reported our clinical experiences of boron neutron capture therapy (BNCT) for the newly diagnosed glioblastoma. The major differences of our protocol from the other past studies were simultaneous use of both sodium borocapate and boronophenylalanine, and combination with fractionated X-ray irradiation. These results showed the efficacy of combination therapy with external beam X-ray irradiation and BNCT. For our future study, we planned the multi-centric phase II clinical study for newly diagnosed glioblastoma patients in Japan (OSAKA-TRIBRAIN0902, NCT00974987).

  10. Localized cortical thickening of the femoral diaphysis captured on an X-ray before alendronate therapy in two cases of atypical femoral fracture

    Energy Technology Data Exchange (ETDEWEB)

    Iizuka, Yoichi [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Shibukawa General Hospital, Department of Orthopedic Surgery, Shibukawa, Gunma (Japan); Takechi, Rumi [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Gunma Cardiovascular Center, Department of Orthopaedic Surgery, Maebashi, Gunma (Japan); Iizuka, Haku; Takagishi, Kenji [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Omodaka, Takuya [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Gunma Central Hospital, Department of Orthopedic Surgery, Maebashi, Gunma (Japan)

    2016-10-15

    We herein report two cases of atypical femoral fracture (AFF). X-ray examinations at the first visit of these two female patients showed a complete fracture of the femoral diaphysis diagnosed as an atypical femoral fracture (AFF). X-rays of these two cases also showed localized cortical thickening of the femoral diaphysis. Both patients had been taking alendronate for more than 3 years because of postmenopausal osteoporosis. We assumed that both of the fractures were associated with the long-term use of alendronate. However, we retrospectively identified localized cortical thickening of the femoral diaphysis on an X-ray taken before the alendronate therapy in both of these cases. Therefore, we suspected a pathogenesis of AFFs in which preexisting stress or an insufficient fracture unrelated to bisphosphonate (BP) therapy and subsequent suppression of bone turnover due to BP administration led to the occurrence of an AFF. The patient underwent surgery using intramedullary nails in both of these cases, followed by the administration of teriparatide, and they were able to walk without any support at the final follow-up examination. (orig.)

  11. Partial Breast Radiation Therapy With Proton Beam: 5-Year Results With Cosmetic Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Bush, David A., E-mail: dbush@llu.edu [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Do, Sharon [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Lum, Sharon; Garberoglio, Carlos [Department of Surgical Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Mirshahidi, Hamid [Department of Medical Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Patyal, Baldev; Grove, Roger; Slater, Jerry D. [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States)

    2014-11-01

    Purpose: We updated our previous report of a phase 2 trial using proton beam radiation therapy to deliver partial breast irradiation (PBI) in patients with early stage breast cancer. Methods and Materials: Eligible subjects had invasive nonlobular carcinoma with a maximal dimension of 3 cm. Patients underwent partial mastectomy with negative margins; axillary lymph nodes were negative on sampling. Subjects received postoperative proton beam radiation therapy to the surgical bed. The dose delivered was 40 Gy in 10 fractions, once daily over 2 weeks. Multiple fields were treated daily, and skin-sparing techniques were used. Following treatment, patients were evaluated with clinical assessments and annual mammograms to monitor toxicity, tumor recurrence, and cosmesis. Results: One hundred subjects were enrolled and treated. All patients completed the assigned treatment and were available for post-treatment analysis. The median follow-up was 60 months. Patients had a mean age of 63 years; 90% had ductal histology; the average tumor size was 1.3 cm. Actuarial data at 5 years included ipsilateral breast tumor recurrence-free survival of 97% (95% confidence interval: 100%-93%); disease-free survival of 94%; and overall survival of 95%. There were no cases of grade 3 or higher acute skin reactions, and late skin reactions included 7 cases of grade 1 telangiectasia. Patient- and physician-reported cosmesis was good to excellent in 90% of responses, was not changed from baseline measurements, and was well maintained throughout the entire 5-year follow-up period. Conclusions: Proton beam radiation therapy for PBI produced excellent ipsilateral breast recurrence-free survival with minimal toxicity. The treatment proved to be adaptable to all breast sizes and lumpectomy cavity configurations. Cosmetic results appear to be excellent and unchanged from baseline out to 5 years following treatment. Cosmetic results may be improved over those reported with photon

  12. Dopaminergic therapy and subthalamic stimulation in Parkinson's disease: a review of 5-year reports.

    Science.gov (United States)

    Romito, Luigi M; Albanese, Alberto

    2010-11-01

    The long-term efficacy and safety of deep brain stimulation (DBS) implant for Parkinson's disease (PD) is described in several recent papers. This procedure has been reported to permit a stable reduction of dopaminergic therapy requirements for up to 5 years, although some expectation of deterioration in non-dopaminergic signs has been recently stated. Our aim is to perform a literature-based review of papers available describing long-term post-operative follow-up after a bilateral implant for subthalamic DBS (STN-DBS). Only peer-reviewed published papers with a post-operative follow-up of at least 5 years were considered. Clinical outcome, disease progression and side effects were assessed at baseline and 2 (or 3 years) and 5 years after surgery. Seven papers were included in the review. A total of 238 patients were analyzed. STN-DBS was confirmed to be an effective treatment for selected patients with PD. In all studies, off-related motor symptoms improved dramatically, compared with pre-implant, at 2 (or 3, according to the study) years and this result persisted at 5-year evaluations. Antiparkinsonian drug reductions, improvements in motor fluctuations and dyskinesias, functional measures and the progression of underlying PD were also reported in all series. Some axial scores, in particular postural stability and speech, improved transiently. Persisting adverse effects included eyelid opening apraxia, weight gain, psychiatric disorders, depression, dysarthria, dyskinesias, and apathy. The present review of the 5-year observations confirms that STN-DBS is a powerful method in the management of PD, but its long-term effects must be thoroughly assessed.

  13. Tuberculosis after one year of combination antiretroviral therapy in Nigeria: a retrospective cohort study.

    Science.gov (United States)

    Akanbi, Maxwell O; Achenbach, Chad J; Feinglass, Joe; Taiwo, Babafemi; Onu, Adamu; Pho, Mai T; Agbaji, Oche; Kanki, Phyllis; Murphy, Robert L

    2013-06-01

    Our objective was to determine tuberculosis (TB) incidence and evaluate TB risk in adults after one or more years of use of combination antiretroviral therapy (cART) through a retrospective cohort study in Jos, Nigeria. We studied a cohort of HIV-infected adults treated with ART for at least 1 year. Based on immunologic and virologic responses to ART, patients were categorized into four groups: CD4 T cell count ≥350 cells/mm(3) and HIV-1 RNA level ≤400 copies/ml (group 1), CD4 T cell count ≥350 cells/mm(3) and HIV-1 RNA level >400 copies/ml (group 2), CD4 T cell count 400 copies/ml (group 4). Time to incident TB for the four groups was analyzed using the Kaplan-Meier method. Cox regression models were used to evaluate predictors of incident TB. In this cohort of 5,093 HIV-infected adults, of which 68.4% were female, with a mean age 35.1 years (standard deviation 9.1 years), we observed 98 cases of incident TB during 4 years and 3 months of follow-up. The overall TB incidence rate was 8.7 cases/1,000 patient-years of follow-up. Adjusted hazards for incident TB were 2.11 (95% CI 0.97-4.61), 2.05 (95% CI 1.10-3.79), and 3.65 (95% CI 1.15-5.06) in group 2, 3, and 4 patients, respectively, compared to group 1. Tuberculosis incidence in patients on ART is driven by poor immunologic and/or virologic response. Optimization of HIV treatment should be prioritized to reduce the burden of TB in this high-risk population.

  14. Capturing appearance

    Science.gov (United States)

    Rushmeier, Holly E.

    2005-01-01

    For computer graphics applications, capturing the appearance parameters of objects (reflectance, transmittance and small scale surface structures), is as important as capturing the overall shape. We briefly review recent approaches developed by the computer graphics community to solve this problem. Excellent results have been obtained by various researchers measuring spatially varying reflectance functions for some classes of objects. We will consider some challenges from two of the remaining problematic classes of objects. First we will describe our experience scanning and modeling the throne of Tutankhamen. The major difficulties in this case were that the base shape was a highly detailed non-convex geometry with complex topology, and the shape was covered by optically uncooperative gold and silver. Then we will discuss some observations from our ongoing project to scan and model historic buildings on the Yale campus. The major difficulties in this second case are quantity of data and the lack of control over acquisition conditions.

  15. Cause-Specific Mortality in HIV-Positive Patients Who Survived Ten Years after Starting Antiretroviral Therapy

    Science.gov (United States)

    May, Margaret T.; Vehreschild, Janne; Obel, Niels; Gill, Michael John; Crane, Heidi; Boesecke, Christoph; Samji, Hasina; Grabar, Sophie; Cazanave, Charles; Cavassini, Matthias; Shepherd, Leah; d’Arminio Monforte, Antonella; Smit, Colette; Saag, Michael; Lampe, Fiona; Hernando, Vicky; Montero, Marta; Zangerle, Robert; Justice, Amy C.; Sterling, Timothy; Miro, Jose; Ingle, Suzanne; Sterne, Jonathan A. C.

    2016-01-01

    Objectives To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996–1999 and survived for more than ten years. Methods We used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA. Results During 50,593 person years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict mortality in models adjusted for patient characteristics ten years after start of antiretroviral therapy. The most frequent causes of death (among 340 classified) were non-AIDS cancer, AIDS, cardiovascular, and liver-related disease. Older age was strongly associated with cardiovascular mortality, injecting drug use transmission with non-AIDS infection and liver-related mortality, and low CD4 and detectable viral replication ten years after starting antiretroviral therapy with AIDS mortality. Five-year mortality risk was <5% in 60% of all patients, and in 30% of those aged over 60 years. Conclusions Viral replication, lower CD4 count, prior AIDS, and transmission via injecting drug use continue to predict higher all-cause and AIDS-related mortality in patients treated with combination antiretroviral therapy for over a decade. Deaths from AIDS and non-AIDS infection are less frequent than deaths from other non-AIDS causes. PMID:27525413

  16. Experimental Studies of Boronophenylalanine ({sup 10}BPA) Biodistribution for the Individual Application of Boron Neutron Capture Therapy (BNCT) for Malignant Melanoma Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Carpano, Marina; Perona, Marina; Rodriguez, Carla [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); Nievas, Susana; Olivera, Maria; Santa Cruz, Gustavo A. [Department of Boron Neutron Capture Therapy, National Atomic Energy Commission, San Martín (Argentina); Brandizzi, Daniel; Cabrini, Romulo [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); School of Dentistry, University of Buenos Aires, Buenos Aires (Argentina); Pisarev, Mario [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); National Research Council of Argentina, Buenos Aires (Argentina); Department of Human Biochemistry, School of Medicine, University of Buenos Aires, Buenos Aires (Argentina); Juvenal, Guillermo Juan [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); National Research Council of Argentina, Buenos Aires (Argentina); Dagrosa, Maria Alejandra, E-mail: dagrosa@cnea.gov.ar [Department of Radiobiology, National Atomic Energy Commission, San Martín (Argentina); National Research Council of Argentina, Buenos Aires (Argentina)

    2015-10-01

    Purpose: Patients with the same histopathologic diagnosis of cutaneous melanoma treated with identical protocols of boron neutron capture therapy (BNCT) have shown different clinical outcomes. The objective of the present studies was to evaluate the biodistribution of boronophenilalanina ({sup 10}BPA) for the potential application of BNCT for the treatment of melanoma on an individual basis. Methods and Materials: The boronophenilalanine (BPA) uptake was evaluated in 3 human melanoma cell lines: MEL-J, A375, and M8. NIH nude mice were implanted with 4 10{sup 6} MEL-J cells, and biodistribution studies of BPA (350 mg/kg intraperitoneally) were performed. Static infrared imaging using a specially modified infrared camera adapted to measure the body infrared radiance of small animals was used. Proliferation marker, Ki-67, and endothelial marker, CD31, were analyzed in tumor samples. Results: The in vitro studies demonstrated different patterns of BPA uptake for each analyzed cell line (P<.001 for MEL-J and A375 vs M8 cells). The in vivo studies showed a maximum average boron concentration of 25.9 ± 2.6 μg/g in tumor, with individual values ranging between 11.7 and 52.0 μg/g of {sup 10}B 2 hours after the injection of BPA. Tumor temperature always decreased as the tumors increased in size, with values ranging between 37°C and 23°C. A significant correlation between tumor temperature and tumor-to-blood boron concentration ratio was found (R{sup 2} = 0.7, rational function fit). The immunohistochemical studies revealed, in tumors with extensive areas of viability, a high number of positive cells for Ki-67, blood vessels of large diameter evidenced by the marker CD31, and a direct logistic correlation between proliferative status and boron concentration difference between tumor and blood (R{sup 2} = 0.81, logistic function fit). Conclusion: We propose that these methods could be suitable for designing new screening protocols applied before melanoma BNCT

  17. Negative symptom improvement during cognitive rehabilitation: results from a 2-year trial of Cognitive Enhancement Therapy.

    Science.gov (United States)

    Eack, Shaun M; Mesholam-Gately, Raquelle I; Greenwald, Deborah P; Hogarty, Susan S; Keshavan, Matcheri S

    2013-08-30

    Cognitive rehabilitation has shown beneficial effects on cognition in patients with schizophrenia, which may also help to improve negative symptoms due to overlapping pathophysiology between these two domains. To better understand the possible relationship between these areas, we conducted an exploratory analysis of the effects of Cognitive Enhancement Therapy (CET) on negative symptoms. Early course schizophrenia outpatients (n=58) were randomized to 2 years of CET or an Enriched Supportive Therapy (EST) control condition. Results revealed significant and medium-sized (d=0.61) differential improvements favoring CET in overall negative symptoms, particularly social withdrawal, affective flattening, and motor retardation. Neurocognitive improvement was associated with reduced negative symptoms in CET, but not EST patients. No relationships were observed between improvements in emotion processing aspects of social cognition, as measured by the Mayer-Salovey-Caruso Emotional Intelligence Test, and negative symptoms. CET represents an effective cognitive rehabilitation intervention for schizophrenia that may also have benefits to negative symptoms. Future studies specifically designed to examine negative symptoms during the course of cognitive rehabilitation are needed.

  18. Shock-wave therapy for tennis and golfer's elbow--1 year follow-up.

    Science.gov (United States)

    Krischek, O; Hopf, C; Nafe, B; Rompe, J D

    1999-01-01

    Thirty patients with chronic medial epicondylitis were treated with low-energy shock waves. They received 500 impulses of 0.08 mJ/mm2 three times at weekly intervals. At 1 year follow-up examinations were performed. According to the Verhaar criteria, only seven patients reached excellent or good results. In eight cases a fair outcome was recorded, and in 14 patients the outcome was poor. Only six patients were satisfied with the treatment. The average relief of pain was 32%. These data were significantly worse than for identically treated patients with chronic tennis elbow. Thus, the question arises as to whether extracorporal shock-wave therapy is indicated in medial epicondylitis.

  19. Therapist adherence and organizational effects on change in youth behavior problems one year after multisystemic therapy.

    Science.gov (United States)

    Schoenwald, Sonja K; Carter, Rickey E; Chapman, Jason E; Sheidow, Ashli J

    2008-09-01

    The current study investigated the relations among therapist adherence to an evidence-based treatment for youth with serious antisocial behavior (i.e., Multisystemic Therapy), organizational climate and structure, and improvement in youth behavior problems one-year post treatment. Participants were 1979 youth and families treated by 429 therapists across 45 provider organizations in North America. Hierarchical Linear Modeling (HLM) results showed therapist adherence predicted improvement in youth behavior. Two structure variables and one climate variable predicted changes in youth behavior, and the climate variable also predicted therapist adherence. No statistical support for formal mediation of organizational effects through adherence was found, though examination of changes in parameter estimates suggest a possible interplay of organizational climate with adherence and youth behavior change.

  20. Enzymatic replacement therapy for Hunter disease: Up to 9 years experience with 17 patients

    Directory of Open Access Journals (Sweden)

    Rossella Parini

    2015-06-01

    Full Text Available Hunter disease is an X-linked lysosomal storage disorder characterized by progressive storage of glycosaminoglycans (GAGs and multi-organ impairment. The central nervous system (CNS is involved in at least 50% of cases. Since 2006, the enzymatic replacement therapy (ERT is available but with no effect on the cognitive impairment, as the present formulation does not cross the blood–brain barrier. Here we report the outcome of 17 Hunter patients treated in a single center. Most of them (11 started ERT in 2006, 3 had started it earlier in 2004, enrolled in the phase III trial, and 3 after 2006, as soon as the diagnosis was made. The liver and spleen sizes and urinary GAGs significantly decreased and normalized throughout the treatment. Heart parameters improved, in particular the left ventricular mass index/m2 decreased significantly. Amelioration of hearing was seen in many patients. Joint range of motion improved in all patients. However, no improvement on respiratory function, eye, skeletal and CNS disease was found. The developmental quotient of patients with a CNS involvement showed a fast decline. These patients were no more testable after 6 years of age and, albeit the benefits drawn from ERT, their quality of life worsened throughout the years. The whole group of patients showed a consistent residual disease burden mainly represented by persistent skeletal disease and frequent need of surgery. This study suggests that early diagnosis and treatment and other different therapies which are able to cross the blood–brain barrier, might in the future improve the MPS II outcome.

  1. Effect of 1 year of discontinuation of raloxifene or estrogen therapy on bone mineral density after 5 years of treatment in healthy postmenopausal women.

    Science.gov (United States)

    Neele, S J M; Evertz, R; De Valk-De Roo, G; Roos, J C; Netelenbos, J C

    2002-04-01

    The beneficial effects of hormone replacement therapy (HRT), selective estrogen receptor modulators (SERMs), or bisphosphonates in the prevention and treatment of osteoporosis in postmenopausal women have been well established. However, little is known about the effects of discontinuation of treatment on bone mineral density. We investigated the effect of 1 year of discontinuation of the SERM raloxifene (Ral; 60 mg and 150 mg), conjugated equine estrogen (CEE; 0.625 mg), and placebo after 5 years of treatment in a double-blind, randomized study. Thirty-eight of 59 healthy and hysterectomized postmenopausal women (mean age 55 years) completed the treatment and 1 year follow-up period. Lumbar spine and femoral neck bone mineral density (BMD) were performed with dual-energy X-ray absorptiometry, before, during, and at the end of treatment, as well as after 1 year of discontinuation of therapy. One year of discontinuation significantly reduced the mean lumbar spine BMD in the raloxifene- and estrogen-treated women (p protect against bone loss after 1 year of withdrawal of therapy, and that the rate of bone loss was not significantly different from that of placebo-treated women.

  2. [Bevacizumab as first-line therapy in metastatic renal cell carcinoma: Progression-free survival for 3 years].

    Science.gov (United States)

    Pichler, R; Horninger, W; Aigner, F; Heidegger, I

    2016-03-01

    We report the case of a 72-year-old woman who was diagnosed in 2006 with renal cell cancer (RCC) and had undergone consecutive tumor nephrectomy (clear-cell RCC, Fuhrmann grade II, stage pT3a, R0). Over the years, the patient underwent several surgical and radiological interventions due to various metastatic lesions. This case report describes the 3-year progression-free survival in a patient who underwent first-line therapy with the monoclonal antibody bevacizumab. Except for hypertension, the patient does not suffer currently from any other side effects of bevacizumab therapy.

  3. Direct access to physical therapy in the Netherlands: results from the first year in community-based physical therapy.

    NARCIS (Netherlands)

    Leemrijse, C.J.; Swinkels, I.C.; Veenhof, C.

    2008-01-01

    BACKGROUND: In 2006, direct access to physical therapy was introduced in the Netherlands. Before this policy measure, evaluation and treatment by a physical therapist were only possible following referral by a physician. OBJECTIVE: The objectives of this study were to investigate how many patients u

  4. ASSESSMENT OF ARTHROSONOGRAPHIC CHANGES DURING LONG-TERM TERAFLEX THERAPY FOR GONARTHROSIS(3-YEAR FOLLOW-UP)

    OpenAIRE

    2011-01-01

    Two hundred and forty-four outpatients with gonarthrosis were examined. The time course of arthrosonographic (the height of the articular cartilage, the volume of intraarticular effusion, the width of the joint cleft, and the degree of osteophytosis) changes were estimated during longterm Teraflex therapy and in control patients. The long-term (3-year) Teraflex therapy was shown to have a restraining impact on the processes of articular cartilage degradation and the progression of artic...

  5. Mild versus moderate stages of Alzheimer's disease: three-year outcomes in a routine clinical setting of cholinesterase inhibitor therapy.

    OpenAIRE

    Wattmo, Carina; Minthon, Lennart; Wallin, Åsa

    2016-01-01

    BACKGROUND: There is an increasing interest in cognitive and functional outcomes in the respective stages of Alzheimer's disease (AD) and in novel therapies particularly for the milder phases of AD. Our aim was to describe and compare various aspects of disease progression in patients with mild versus moderate AD in routine clinical practice of cholinesterase inhibitor (ChEI) therapy. METHODS: This 3-year, prospective, observational, multicentre study included 1021 participants. Of the...

  6. An overview of 5 years of patient self-referral for physical therapy in the Netherlands.

    NARCIS (Netherlands)

    Swinkels, I.C.S.; Kooijman, M.K.; Spreeuwenberg, P.M.; Bossen, D.; Leemrijse, C.J.; Dijk, C.E. van; Verheij, R.; Bakker, D.H. de; Veenhof, C.

    2014-01-01

    Background: Self-referral to physical therapy was introduced in 2006 in the Netherlands. Internationally, debate on self-referral is still ongoing. Objective: To evaluate the effects of self-referral to physical therapy in the Netherlands, focusing on volume of general practice and physical therapy

  7. Urethral Pain Among Prostate Cancer Survivors 1 to 14 Years After Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Pettersson, Niclas, E-mail: niclas.pettersson@vgregion.se [Department of Physics and Biomedical Engineering, Sahlgrenska University Hospital, Goeteborg (Sweden); Olsson, Caroline [Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Goeteborg (Sweden); Tucker, Susan L. [Department of Bioinformatics and Computational Biology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Alsadius, David; Wilderaeng, Ulrica [Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Goeteborg (Sweden); Johansson, Karl-Axel [Department of Physics and Biomedical Engineering, Sahlgrenska University Hospital, Goeteborg (Sweden); Steineck, Gunnar [Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Goeteborg (Sweden)

    2013-01-01

    Purpose: To investigate how treatment-related and non-treatment-related factors impact urethral pain among long-term prostate cancer survivors. Methods and Materials: Men treated for prostate cancer with radiation therapy at the Sahlgrenska University Hospital in Goeteborg, Sweden from 1993 to 2006 were approached with a study-specific postal questionnaire addressing symptoms after treatment, including urethral burning pain during urination (n=985). The men had received primary or salvage external-beam radiation therapy (EBRT) or EBRT in combination with brachytherapy (BT). Prescribed doses were commonly 70 Gy in 2.0-Gy fractions for primary and salvage EBRT and 50 Gy plus 2 Multiplication-Sign 10.0 Gy for EBRT + BT. Prostatic urethral doses were assessed from treatment records. We also recruited 350 non-pelvic-irradiated, population-based controls matched for age and residency to provide symptom background rates. Results: Of the treated men, 16% (137 of 863) reported urethral pain, compared with 11% (27 of 242) of the controls. The median time to follow-up was 5.2 years (range, 1.1-14.3 years). Prostatic urethral doses were similar to prescription doses for EBRT and 100% to 115% for BT. Fractionation-corrected dose and time to follow-up affected the occurrence of the symptom. For a follow-up {>=}3 years, 19% of men (52 of 268) within the 70-Gy EBRT + BT group reported pain, compared with 10% of men (23 of 222) treated with 70 Gy primary EBRT (prevalence ratio 1.9; 95% confidence interval 1.2-3.0). Of the men treated with salvage EBRT, 10% (20 of 197) reported urethral pain. Conclusions: Survivors treated with EBRT + BT had a higher risk for urethral pain compared with those treated with EBRT. The symptom prevalence decreased with longer time to follow-up. We found a relationship between fractionation-corrected urethral dose and pain. Among long-term prostate cancer survivors, the occurrence of pain was not increased above the background rate for prostatic urethral

  8. Twenty years of electroconvulsive therapy in a psychiatric unit at a university general hospital

    Directory of Open Access Journals (Sweden)

    Amilton dos Santos Jr.

    2013-01-01

    Full Text Available Objective: To describe the sociodemographic and clinical profile of patients who underwent electroconvulsive therapy (ECT at a university general hospital. Method: In this retrospective study, records from all patients undergoing ECT between January 1988 and January 2008 at the psychiatric unit of the general hospital of Universidade Estadual de Campinas (UNICAMP were reviewed. Telephone contact was made with patients/relatives to collect follow-up data. Results: A total of 200 charts were reviewed. The majority of patients were women, with a mean age of 39 years, and history of psychiatric hospitalization. The main indications for ECT were depression and catatonia. Complications were observed in less than half of the cases, and most were temporary and not severe. There was a good psychiatric outcome for 89.7% of the patients, especially for catatonic patients (100%, p = 0.02. Thirty-four percent of the cases were later contacted by telephone calls, at a mean of 8.5 years between the procedure and the contact. Among these, three (1.5% reported persistent memory disorders and 73% considered ECT a good treatment. Conclusion: ECT has been performed according to international guidelines. In the vast majority of cases, undesirable effects were temporary and not severe. Response to ECT was positive in most cases, particularly in catatonic patients.

  9. Ten years of "Optimal Therapy in Advanced Ovarian Cancer. Update" meeting.

    Science.gov (United States)

    Poveda, A

    2008-01-01

    The International Symposium on Advanced Ovarian Cancer: Optimal Therapy was founded by Dr. Andrés Poveda and Prof. Jan B. Vermorken, and each edition has been directed by them. The 6th edition was held on March 2, 2007. This symposium is organized every other year by GEICO (Grupo Español de Investigación de Cáncer de Ovario/Spanish Ovarian Cancer Research Group), under the auspices of the Spanish Society of Medical Oncology (SEOM), the Gynecologic Cancer Intergroup (GCIG), and the European Society of Medical Oncology (ESMO) Educational Committee for its Medical Oncology Recertification Approval (ESMO/MORA) Program. One hundred and fifty people attended the symposium's 1st edition, held in 1996. Since then, the interest in this meeting has increased. Last year, almost three hundred people coming not only from Spain but also from Europe, North and Latin America, Asia, and Australia were present in the symposium. This is a great challenge for us. Some important international cooperative groups from Europe, America, and Australia collaborate with this symposium, such as GOG, NCIC, EORTC, AGO, Scottish Group, ICON, GINECO, NSGO, ANZGOG, and others.

  10. Occupational exposure of nursing staff working with radioiodine therapy during 11 years

    Energy Technology Data Exchange (ETDEWEB)

    Calegaro, Jose Ulisses Manzzini; Teixeira, Sandra Mara Pessano [Hospital de Base do Distrito Federal, Brasilia, DF (Brazil). Centro de Medicina Nuclear]. E-mail: jcalegaro@uol.com.br

    2007-07-15

    Objective: The present study was aimed at evaluating the occupational exposure of nursing staff in charge of inpatients undergoing {sup 131}I therapy during 11 years. Materials and methods: The exposure situations were classified according to a questionnaire answered by three nursing attendants, correlating the procedures with activities, distances and amount of time in the iodotherapy room. Records of received doses by two types of dosimeters were evaluated over two subsequent periods. In both periods the nursing attendants received instructions about radiological protection. Results: In usual situations, their amount of time in the iodotherapy room was in compliance with the standard time established by the service. In unusual situations, where the patient needed assistance for mobility, the exposure period was above the standard. However, this exposure occurs casually (only one or two times a year). During the period between 1993 and 1999 (dosimetric films) there were ten dose records, all of them at record level. From 2000 to 2003 (thermoluminescent dosimeters) ten dose records were also obtained, with only one of them at the investigation level. During this study period, the mean {sup 131}I activity was doubled. Conclusion: Despite the increased levels of activity there was no significant increase in dose to nursing attendants. (author)

  11. Quality of life of elderly ischaemic stroke patients one year after thrombolytic therapy. A comparison between patients with and without thrombolytic therapy

    Directory of Open Access Journals (Sweden)

    de Weerd Leonie

    2012-07-01

    Full Text Available Abstract Background An observational study to examine whether thrombolytic therapy in stroke patients realizes better quality of life outcomes compared to patients without thrombolytic therapy one year after stroke. We also examined whether daily functioning, mental functioning and activities improved after thrombolytic treatment. Methods A total of 88 stroke patients were interviewed at home one year post-stroke. Health-related quality of life (HRQOL was assessed using the RAND-36, disability with the Barthel Index, depression and anxiety with the Hospital Anxiety and Depression Scale, and a questionnaire about patient way of life was completed. People aged under 60, moving to a nursing home or with a haemorrhage were excluded. Results The thrombolysis group (TG had more severe stroke (higher NIHSS scores and were younger than the group without thrombolytic therapy (WTG. The primary outcome was HRQOL, which was high and nearly identical in both groups, however the TG had significantly better HRQOL for the ‘mental health’ and ‘vitality’ scales. Patients who stopped or reduced their hobbies because of stroke had a significantly worse HRQOL. One year after stroke, more patients in the TG were totally or severely ADL dependent (12% TG and 0% WTG, p = 0.022. The level of dependence decreased in the TG (p = 0.042 and worsened in the WTG (p  Conclusion No major differences in the primary outcome (HRQOL could be found between the two groups. In addition, no essential difference could be found in mental functioning and participation. We expected that patients undergoing thrombolytic therapy would have worse quality of life because of the greater initial severity of their stroke. Therefore, thrombolytic therapy seems to be of great importance in achieving better quality of life in ischemic stroke patients who respond to this therapy.

  12. Surgical therapies for corneal perforations: 10 years of cases in a tertiary referral hospital

    Directory of Open Access Journals (Sweden)

    Yokogawa H

    2014-10-01

    Full Text Available Hideaki Yokogawa, Akira Kobayashi, Natsuko Yamazaki, Toshinori Masaki, Kazuhisa Sugiyama Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, JapanPurpose: To report surgical therapies for corneal perforations in a tertiary referral hospital.Methods: Thirty-one eyes of 31 patients (aged 62.4±18.3 years with surgically treated corneal perforations from January 2002 to July 2013 were included in this study. Demographic data such as cause of corneal perforation, surgical procedures, and visual outcomes were retrospectively analyzed.Results: The causes of corneal perforation (n=31 were divided into infectious (n=8, 26% and noninfectious (n=23, 74% categories. Infectious causes included fungal ulcer, herpetic stromal necrotizing keratitis, and bacterial ulcer. The causes of noninfectious keratopathy included corneal melting after removal of a metal foreign body, severe dry eye, lagophthalmos, canaliculitis, the oral anticancer drug S-1, keratoconus, rheumatoid arthritis, neurotrophic ulcer, atopic keratoconjunctivitis, and unknown causes. Initial surgical procedures included central large corneal graft (n=17, small corneal graft (n=7, and amniotic membrane transplantation (n=7. In two cases the perforation could not be sealed during the first surgical treatment and required subsequent procedures. All infectious keratitis required central large penetrating keratoplasty to obtain anatomical cure. In contrast, several surgical options were used for the treatment of noninfectious keratitis. After surgical treatment, anatomical cure was obtained in all cases. Mean postoperative best corrected visual acuity was better at 6 months (logMAR 1.3 than preoperatively (logMAR 1.8.Conclusion: Surgical therapies for corneal perforations in our hospital included central large lamellar/penetrating keratoplasty, small peripheral patch graft, and amniotic membrane transplantation. All treatments were effective. Corneal

  13. Toward a clinical application of ex situ boron neutron capture therapy for lung tumors at the RA-3 reactor in Argentina

    Energy Technology Data Exchange (ETDEWEB)

    Farías, R. O.; Trivillin, V. A.; Portu, A. M.; Schwint, A. E.; González, S. J., E-mail: srgonzal@cnea.gov.ar [Comisión Nacional de Energía Atómica (CNEA), San Martín 1650, Argentina and Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires 1033 (Argentina); Garabalino, M. A.; Monti Hughes, A.; Pozzi, E. C. C.; Thorp, S. I.; Curotto, P.; Miller, M. E.; Santa Cruz, G. A.; Saint Martin, G. [Comisión Nacional de Energía Atómica (CNEA), San Martín 1650 (Argentina); Ferraris, S.; Santa María, J.; Rovati, O.; Lange, F. [CIDME, Universidad Maimónides, Buenos Aires 1405 (Argentina); Bortolussi, S. [Istituto Nazionale di Fisica Nucleare, Sezione di Pavia 27100 (Italy); Altieri, S. [Istituto Nazionale di Fisica Nucleare, Sezione di Pavia 27100, Italy and Dipartimento di Fisica, Università di Pavia, Pavia 27100 (Italy)

    2015-07-15

    Purpose: Many types of lung tumors have a very poor prognosis due to their spread in the whole organ volume. The fact that boron neutron capture therapy (BNCT) would allow for selective targeting of all the nodules regardless of their position, prompted a preclinical feasibility study of ex situ BNCT at the thermal neutron facility of RA-3 reactor in the province of Buenos Aires, Argentina. (L)-4p-dihydroxy-borylphenylalanine fructose complex (BPA-F) biodistribution studies in an adult sheep model and computational dosimetry for a human explanted lung were performed to evaluate the feasibility and the therapeutic potential of ex situ BNCT. Methods: Two kinds of boron biodistribution studies were carried out in the healthy sheep: a set of pharmacokinetic studies without lung excision, and a set that consisted of evaluation of boron concentration in the explanted and perfused lung. In order to assess the feasibility of the clinical application of ex situ BNCT at RA-3, a case of multiple lung metastases was analyzed. A detailed computational representation of the geometry of the lung was built based on a real collapsed human lung. Dosimetric calculations and dose limiting considerations were based on the experimental results from the adult sheep, and on the most suitable information published in the literature. In addition, a workable treatment plan was considered to assess the clinical application in a realistic scenario. Results: Concentration-time profiles for the normal sheep showed that the boron kinetics in blood, lung, and skin would adequately represent the boron behavior and absolute uptake expected in human tissues. Results strongly suggest that the distribution of the boron compound is spatially homogeneous in the lung. A constant lung-to-blood ratio of 1.3 ± 0.1 was observed from 80 min after the end of BPA-F infusion. The fact that this ratio remains constant during time would allow the blood boron concentration to be used as a surrogate and indirect

  14. The effect of dance therapy on the balance of women over 60 years of age: The influence of dance therapy for the elderly.

    Science.gov (United States)

    Filar-Mierzwa, Katarzyna; Długosz, Małgorzata; Marchewka, Anna; Dąbrowski, Zbigniew; Poznańska, Anna

    2016-08-23

    Dance therapy is a physical activity that can lead to balance improvement in older adults. The aim of the study was to evaluate the effects of dance therapy on balance and risk of falls in older women. Twenty-four older women (mean age 66.4 years old) attended dance sessions for three months. Pretest/posttests were completed using the Postural Stability Test, the Limits of Stability Test, and the Fall Risk Test M-CTSIB. Results showed the Limits of Stability Test was significantly higher (17.5%) after dance classes. Regular use of dance therapy shows promise in improving balance by increasing the limits of stability.

  15. Pulsed estrogen therapy in prevention of postmenopausal osteoporosis. A 2-year randomized, double blind, placebo-controlled study

    DEFF Research Database (Denmark)

    Nielsen, Therese F; Ravn, Pernille; Bagger, Yu Z

    2004-01-01

    The aim of this study was to evaluate the efficacy of pulsed estrogen therapy (intranasal 17beta-estradiol) in the prevention of postmenopausal bone loss. A total of 386 women (40-65 years old), less than 5 years past menopause, were randomized to intranasal placebo, 17beta-estradiol 150 micro g...... tolerance were good. This study demonstrates that pulsed estrogen therapy at the dose of 150 microg and 300-microg per day prevents bone loss in a dose-dependant manner at each site studied, and normalizes bone turnover markers to premenopausal levels....

  16. Acupuncture and occlusal splint therapy in the treatment of craniomandibular disorders. II. A 1-year follow-up study.

    Science.gov (United States)

    List, T; Helkimo, M

    1992-12-01

    Eighty patients, of whom 22 were men and 58 women, participated in a 1-year follow-up study. All participants in the study showed signs and symptoms of craniomandibular disorders (CMD) and had had pain for more than 6 months at treatment start. The patients were randomly assigned to either acupuncture or occlusal splint therapy. Those patients who did not respond to either of the treatment modes were offered various additional therapies. The result showed that 57% of the patients who received acupuncture and 68% of the patients treated with occlusal splint therapy benefited subjectively (p < 0.01) and clinically (p < 0.001) from the treatment over a 12-month period. No statistically significant difference was found between the two groups as to the assessment variables. Those patients who received various additional therapies after acupuncture and/or occlusal splint therapy responded favorably to additional treatment in only a few instances. The study showed that acupuncture gave positive results similar to those of occlusal splint therapy in patients with primarily myogenic CMD symptoms over a 1-year follow-up period.

  17. Photodynamic Therapy for Upper Gastrointestinal Cancers during Past 25 Years in China

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To evaluate the status of photodynamic therapy (PDT) for upper gastrointestinal cancers, and then discuss how to solve the problems that hinder the development of PDT. Methods: A total of 30 pertinent literatures about PDT for upper gastrointestinal cancers during past 25 years were collected through the retrieval of several related medical databases (Chinese Medical Current Contents, China Bio-Medical Bibliographic Database, China Journal Fulltext Database). The data, including the gender, age of patients, tumor position, pathologic findings, treatment efficacy, adverse effects and the applied laser and photosensitizer, were statistically analyzed.Results: For all the 1687 cases with upper gastrointestinal cancers, the excellent-effective rate (complete remission or prominent remission) and effective rate (complete remission or prominent remission or minor remission) were 53.2% and 87%, respectively. The therapeutic effect of combined treatment(PDT with other methods) was superior to that of PDT (u=4.456, P<0.01). All the involved pathological types were sensitive to PDT. Different photosensitizers and lasers were used by different authors, but all of them were effective without any serious side effect. Conclusion: PDT shows a radical effect on the tumors of early stage and a favorable palliative effect on the tumors of advanced stage, so it is one of the optional strategies for the treatment of upper gastrointestinal cancers.

  18. Alveolar Rhabdomyosarcoma in a 69-Year-Old Woman Receiving Glucagon-Like Peptide-2 Therapy

    Directory of Open Access Journals (Sweden)

    Laura E. Zyczynski

    2015-01-01

    Full Text Available A 69-year-old woman was diagnosed with alveolar rhabdomyosarcoma (ARMS of the nasopharynx. She has a history of catastrophic thromboembolic event in the abdomen that caused short-gut syndrome and dependence on total parenteral nutrition (TPN twelve hours per day. She was treated for short-gut syndrome with teduglutide, a glucagon-like peptide-2 (GLP-2 analog, which led to reduction of TPN requirements. However, a few months later, she developed metastatic alveolar rhabdomyosarcoma. Though a causative relationship is unlikely between the peptide and ARMS due to the brief time course between teduglutide therapy and sarcoma diagnosis, neoplastic growth may have been accelerated by the GLP-2 analog, causing release of IGF-1. The transmembrane receptor for IGF-1 is frequently overexpressed in ARMS and is implicated in cell proliferation and metastatic behavior. This case describes a rare incidence of metastatic alveolar rhabdomyosarcoma in a sexagenarian and possibly the first case reported associated with the use of teduglutide. Teduglutide was discontinued due to a potential theoretical risk of acceleration of sarcoma growth, and the patient’s rhabdomyosarcoma is in remission following sarcoma chemotherapy.

  19. Anthroposophic therapy for children with chronic disease: a two-year prospective cohort study in routine outpatient settings

    Directory of Open Access Journals (Sweden)

    Willich Stefan N

    2009-06-01

    Full Text Available Abstract Background Many children with chronic disease use complementary therapies. Anthroposophic treatment for paediatric chronic disease is provided by physicians and differs from conventional treatment in the use of special therapies (art therapy, eurythmy movement exercises, rhythmical massage therapy and special medications. We studied clinical outcomes in children with chronic diseases under anthroposophic treatment in routine outpatient settings. Methods In conjunction with a health benefit program, consecutive outpatients starting anthroposophic treatment for any chronic disease participated in a prospective cohort study. Main outcome was disease severity (Disease and Symptom Scores, physicians' and caregivers' assessment on numerical rating scales 0–10. Disease Score was documented after 0, 6, and 12 months, Symptom Score after 0, 3, 6, 12, 18, and 24 months. Results A total of 435 patients were included. Mean age was 8.2 years (standard deviation 3.3, range 1.0–16.9 years. Most common indications were mental disorders (46.2% of patients; primarily hyperkinetic, emotional, and developmental disorders, respiratory disorders (14.0%, and neurological disorders (5.7%. Median disease duration at baseline was 3.0 years (interquartile range 1.0–5.0 years. The anthroposophic treatment modalities used were medications (69.2% of patients, eurythmy therapy (54.7%, art therapy (11.3%, and rhythmical massage therapy (6.7%. Median number of eurythmy/art/massage therapy sessions was 12 (interquartile range 10–20, median therapy duration was 118 days (interquartile range 78–189 days. From baseline to six-month follow-up, Disease Score improved by average 3.00 points (95% confidence interval 2.76–3.24 points, p Conclusion Children under anthroposophic treatment had long-term improvement of chronic disease symptoms. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study

  20. Loss to clinic and five-year mortality among HIV-infected antiretroviral therapy initiators.

    Directory of Open Access Journals (Sweden)

    Jessie K Edwards

    Full Text Available Missing outcome data due to loss to follow-up occurs frequently in clinical cohort studies of HIV-infected patients. Censoring patients when they become lost can produce inaccurate results if the risk of the outcome among the censored patients differs from the risk of the outcome among patients remaining under observation. We examine whether patients who are considered lost to follow up are at increased risk of mortality compared to those who remain under observation. Patients from the US Centers for AIDS Research Network of Integrated Clinical Systems (CNICS who newly initiated combination antiretroviral therapy between January 1, 1998 and December 31, 2009 and survived for at least one year were included in the study. Mortality information was available for all participants regardless of continued observation in the CNICS. We compare mortality between patients retained in the cohort and those lost-to-clinic, as commonly defined by a 12-month gap in care. Patients who were considered lost-to-clinic had modestly elevated mortality compared to patients who remained under observation after 5 years (risk ratio (RR: 1.2; 95% CI: 0.9, 1.5. Results were similar after redefining loss-to-clinic as 6 months (RR: 1.0; 95% CI: 0.8, 1.3 or 18 months (RR: 1.2; 95% CI: 0.8, 1.6 without a documented clinic visit. The small increase in mortality associated with becoming lost to clinic suggests that these patients were not lost to care, rather they likely transitioned to care at a facility outside the study. The modestly higher mortality among patients who were lost-to-clinic implies that when we necessarily censor these patients in studies of time-varying exposures, we are likely to incur at most a modest selection bias.

  1. Optimal moderator materials at various proton energies considering photon dose rate after irradiation for an accelerator-driven ⁹Be(p, n) boron neutron capture therapy neutron source.

    Science.gov (United States)

    Hashimoto, Y; Hiraga, F; Kiyanagi, Y

    2015-12-01

    We evaluated the accelerator beam power and the neutron-induced radioactivity of (9)Be(p, n) boron neutron capture therapy (BNCT) neutron sources having a MgF2, CaF2, or AlF3 moderator and driven by protons with energy from 8 MeV to 30 MeV. The optimal moderator materials were found to be MgF2 for proton energies less than 10 MeV because of lower required accelerator beam power and CaF2 for higher proton energies because of lower photon dose rate at the treatment position after neutron irradiation.

  2. Development of electrostatic therapy in recent years; Saikin no seidenki ryoho

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, S. [Chuo Univ., Tokyo (Japan)

    1998-08-25

    Accompanying the differentiation and development of electric engineering and medicine, the therapy in the form of loading a body entirely with static electricity is developed to therapies with the portions to be treated as the objects, such as the introduction of ionized chemicals to the portion to be treated by a direct current; twitch stimulus of paralytic muscle by faradism; thermotherapy with high frequency; and the like. In this paper, the history, kinds and effects of electrostatic therapy are described. Electrostatic therapy instruments are mainly divided in to three kinds including alternating current type potential therapy instruments; direct current type potential therapy instruments and AC-DC multiple type potential therapy instruments. Since the greatest characteristics of the electrostatic therapy instrument is the simple usage, the direct current type potential therapy instrument which was first developed for medical department are transferred to general patients whereby the functions of the instrument are not used effectively and sufficiently. Further, the effects of these instruments can be understood from the phenomenal aspect while there are still many unclear points needing the examination form engineering field. 26 refs., 6 figs., 1 tab.

  3. More than 10 years survival with sequential therapy in a patient with advanced renal cell carcinoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, J.L.; Wang, F.L.; Yi, X.M.; Qin, W.J.; Wu, G.J. [Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi' an, Shaanxi (China); Huan, Y. [Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi' an, Shaanxi (China); Yang, L.J.; Zhang, G.; Yu, L.; Zhang, Y.T.; Qin, R.L.; Tian, C.J. [Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi' an, Shaanxi (China)

    2014-10-31

    Although radical nephrectomy alone is widely accepted as the standard of care in localized treatment for renal cell carcinoma (RCC), it is not sufficient for the treatment of metastatic RCC (mRCC), which invariably leads to an unfavorable outcome despite the use of multiple therapies. Currently, sequential targeted agents are recommended for the management of mRCC, but the optimal drug sequence is still debated. This case was a 57-year-old man with clear-cell mRCC who received multiple therapies following his first operation in 2003 and has survived for over 10 years with a satisfactory quality of life. The treatments given included several surgeries, immunotherapy, and sequentially administered sorafenib, sunitinib, and everolimus regimens. In the course of mRCC treatment, well-planned surgeries, effective sequential targeted therapies and close follow-up are all of great importance for optimal management and a satisfactory outcome.

  4. Incidence of fractures of the femur, including subtrochanteric, up to 8 years since initiation of oral bisphosphonate therapy

    DEFF Research Database (Denmark)

    Pazianas, M; Abrahamsen, B; Wang, Y;

    2012-01-01

    In a cohort study of users of bisphosphonates, we evaluated the incidence of fragility fractures at all sites on the femur following for up to 8 years of therapy with alendronate or risedronate. We did not find evidence for a reversal of fracture protection with long-term use of bisphosphonates. ...

  5. Cause-Specific Mortality in HIV-Positive Patients Who Survived Ten Years after Starting Antiretroviral Therapy

    DEFF Research Database (Denmark)

    Trickey, Adam; May, Margaret T; Vehreschild, Janne

    2016-01-01

    OBJECTIVES: To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for more than ten years. METHODS: We used data from 18 European and North American HIV cohort studies contributing to the Antiretro...

  6. [Extreme dietary selectivity following liver transplantation in a 5-year-old girl; management via behavior therapy

    NARCIS (Netherlands)

    Moor, J.M.H. de; Brons, E.; Kokke, F.T.; Vos, H.; Tolboom, J.J.M.

    2004-01-01

    In a 5.1-year-old girl who had been treated by surgical correction of biliary atresia and total orthotopic liver transplantation, extreme dietary selectivity was noted; this was treated by behaviour therapy. On entry in the rehabilitation centre, she manifested malnutrition along with a variety of g

  7. Successful treatment of a radicular groove by intentional replantation and Emdogain therapy: four years follow-up.

    Science.gov (United States)

    Al-Hezaimi, Khalid; Naghshbandi, Jafar; Simon, James H S; Rotstein, Ilan

    2009-03-01

    Radicular groove is an anatomical malformation that often causes severe periodontal defects. Treatments of such an anomaly present a clinical challenge to the operator. Presented is a case of successful treatment of radicular groove associated with a maxillary lateral incisor of a 15-year-old girl. A combination of endodontics, intentional replantation, and Emdogain therapy was used. At 4-year follow-up, the patient was comfortable and complete resolution of the periapical pathology was evident.

  8. Invited commentary: hormone therapy and risk of coronary heart disease why renew the focus on the early years of menopause?

    Science.gov (United States)

    Manson, JoAnn E; Bassuk, Shari S

    2007-09-01

    After the initial report from the Women's Health Initiative estrogen-progestin trial, which found that menopausal hormone therapy was associated with an increased risk of coronary heart disease in the overall cohort (age range: 50-79 years; mean age: 63 years), researchers took a closer look at the data from this and other studies, focusing on the timing of initiation of such therapy. The results suggest that hormone therapy may have a beneficial effect on the heart if started in early menopause, when a woman's arteries are still likely to be relatively healthy, but a harmful effect if started in late menopause, when advanced atherosclerosis may be present. The implication of the timing hypothesis for clinical practice is not that recently menopausal women be given hormone therapy for coronary heart disease prevention but rather that clinicians can be reassured about cardiac risks when considering short-term use of hormone therapy for vasomotor symptom relief in such women. The reduction in vasomotor symptoms must be weighed against other risks and benefits of treatment, but coronary disease is typically not a major factor in the equation for women who are recently menopausal.

  9. Five-Year Outcomes from 3 Prospective Trials of Image-Guided Proton Therapy for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mendenhall, Nancy P., E-mail: menden@shands.ufl.edu [University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Hoppe, Bradford S.; Nichols, Romaine C.; Mendenhall, William M.; Morris, Christopher G.; Li, Zuofeng; Su, Zhong [University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Williams, Christopher R.; Costa, Joseph [Division of Urology, College of Medicine, University of Florida, Jacksonville, Florida (United States); Henderson, Randal H. [University of Florida Proton Therapy Institute, Jacksonville, Florida (United States)

    2014-03-01

    Purpose: To report 5-year clinical outcomes of 3 prospective trials of image-guided proton therapy for prostate cancer. Methods and Materials: A total of 211 prostate cancer patients (89 low-risk, 82 intermediate-risk, and 40 high-risk) were treated in institutional review board-approved trials of 78 cobalt gray equivalent (CGE) in 39 fractions for low-risk disease, 78 to 82 CGE for intermediate-risk disease, and 78 CGE with concomitant docetaxel therapy followed by androgen deprivation therapy for high-risk disease. Toxicities were graded according to Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. Median follow-up was 5.2 years. Results: Five-year rates of biochemical and clinical freedom from disease progression were 99%, 99%, and 76% in low-, intermediate-, and high-risk patients, respectively. Actuarial 5-year rates of late CTCAE, version 3.0 (or version 4.0) grade 3 gastrointestinal and urologic toxicity were 1.0% (0.5%) and 5.4% (1.0%), respectively. Median pretreatment scores and International Prostate Symptom Scores at >4 years posttreatment were 8 and 7, 6 and 6, and 9 and 8, respectively, among the low-, intermediate-, and high-risk patients. There were no significant changes between median pretreatment summary scores and Expanded Prostate Cancer Index Composite scores at >4 years for bowel, urinary irritative and/or obstructive, and urinary continence. Conclusions: Five-year clinical outcomes with image-guided proton therapy included extremely high efficacy, minimal physician-assessed toxicity, and excellent patient-reported outcomes. Further follow-up and a larger patient experience are necessary to confirm these favorable outcomes.

  10. Albendazole therapy of hydatid disease: 2-year follow-up of 40 cases.

    Science.gov (United States)

    el-Mufti, M; Kamag, A; Ibrahim, H; Taktuk, S; Swaisi, I; Zaidan, A; Sameen, A; Shimbish, F; Bouzghaiba, W; Haasi, S

    1993-06-01

    Forty patients with 63 Echinococcus granulosus cysts affecting different sites were treated with albendazole and have been followed up for at least 24 months from completion of therapy. Twenty-one patients (53%) with 37 cysts (59%) showed evidence of healing. The criteria and pattern of healing are outlined. The most serious complication of albendazole therapy was hepatoxic jaundice, which occurred in 5% of patients. Recurrence during the observation period was encountered in 9.5% of patients with a positive response. It is suggested that patients suffering from uncomplicated hydatid disease should be given the benefit of a trial course of albendazole therapy, before surgery is undertaken.

  11. A Content Analysis of Quantitative Research in Journal of Marital and Family Therapy: A 10-Year Review.

    Science.gov (United States)

    Parker, Elizabeth O; Chang, Jennifer; Thomas, Volker

    2016-01-01

    We examined the trends of quantitative research over the past 10 years in the Journal of Marital and Family Therapy (JMFT). Specifically, within the JMFT, we investigated the types and trends of research design and statistical analysis within the quantitative research that was published in JMFT from 2005 to 2014. We found that while the amount of peer-reviewed articles have increased over time, the percentage of quantitative research has remained constant. We discussed the types and trends of statistical analysis and the implications for clinical work and training programs in the field of marriage and family therapy.

  12. Triple-class virologic failure in HIV-infected patients undergoing antiretroviral therapy for up to 10 years

    DEFF Research Database (Denmark)

    Lodwick, Rebecca; Costagliola, Dominique; Reiss, Peter;

    2010-01-01

    the rate of triple-class virologic failure (TCVF) in patients within the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) who started antiretroviral therapy (ART) that included a nonnucleoside reverse-transcriptase inhibitor (NNRTI) or a ritonavir-boosted protease inhibitor (PI...... to whether the initial regimen was NNRTI or PI/r based (P = .11). By 5 years after starting a PI/r regimen as second-line therapy, 46% of patients had developed TCVF. CONCLUSIONS: The rate of virologic failure of the 3 original drug classes is low, but not negligible, and does not appear to diminish over...

  13. Body composition in adults with Type 1 diabetes at onset and during the first year of insulin therapy

    DEFF Research Database (Denmark)

    Rosenfalck, A M; Almdal, Thomas Peter; Hilsted, J;

    2002-01-01

    index (BMI) 20.8 +/- 1.6 (19.2-23.4) kg/m2, body composition was estimated by means of dual-energy X-ray absorptiometry (DXA) whole body scanning supplemented by estimation of total body water (TBW) (isotope dilution technique with 3H2O) at diagnosis and after 1, 3, 6 and 12 months of insulin therapy......AIMS: To describe body composition in patients with Type 1 diabetes at diagnosis and during the first year after initiation of insulin therapy. RESEARCH DESIGN AND METHODS: In 10 (eight male and two female) newly onset Type 1 patients, age 31.5 +/- 3.2 years (27-37 years) (sd and range), body mass...

  14. Retinal characteristics during 1 year of insulin pump therapy in type 1 diabetes

    DEFF Research Database (Denmark)

    Klefter, Oliver Niels; Hommel, Eva; Munch, Inger Christine;

    2016-01-01

    PURPOSE: To investigate changes in retinal metabolism, function, structure and morphology in relation to initiation of insulin pump therapy (continuous subcutaneous insulin infusion, CSII). METHODS: Visual acuity, retinopathy level, dark adaptation kinetics, retinal and subfoveal choroidal thickn...

  15. Catamnesis results of an inpatient neuro-otologic and psychosomatic tinnitus therapy 1-5 years after discharge.

    Science.gov (United States)

    Schaaf, H; Weiß, S; Hesse, G

    2017-02-01

    Treating tinnitus with the resources offered in hospitals can become necessary for patients suffering from complex tinnitus if a high symptom severity, usually accompanied by a corresponding psychosomatic comorbidity, is present. For such costly therapies, for example, the neuro-otologic psychosomatic tinnitus therapy (NPT) examined here, the long-term effect is particularly important; however, reliable catamnesis studies for inpatient treatments are not yet available. Data from 169 (from a total of 327 contacted) inpatients suffering from complex tinnitus were analysed here. To assess the tinnitus stress, the Mini-Tinnitus Questionnaire (Mini-TF12-In German language) according to Hiller and Goebel [1], and for the assessment of the anxiety and depression element, the German version of the Hospitality Anxiety and Depression Score (HADS) [2] were analysed at the start of the therapy, at the end of the therapy and at the earliest 1 year (up to 5 years) after discharge from inpatient treatment. The data were correlated with the current hearing status. In addition, the subjectively perceived effect factors of the therapy as well as the therapies continued outside of hospital were queried. On average, the therapy lasted 39.3 days (SD 13.6) = 5.6 weeks, and the mean of the follow-up time was 38.5 months (12-70 months) (SD 18). The therapy focused on daily neuro-otologic counselling, the improvement of the concrete hearing ability, an audio-therapy as well as frequent individual and group psychotherapy based on neuro-otology. 53.8 % of patients experienced relevant hearing loss (according to WHO criteria) which needed to be treated in addition to tinnitus. Both at the end of the therapy and the follow-up consultation, a significant improvement of the tinnitus stress and a continuing significant improvement of the depression and anxiety element could be achieved in the HADS with high effect levels ranging from 1 to 2.5. Patients who did not improve (n = 7) or

  16. [Antiretroviral therapy in HIV-infected children and adolescents: lessons learned in 30 years of the epidemic].

    Science.gov (United States)

    Bazin, Gabriela Ricordi; Gaspar, Mariza Curto Saavedra; Silva, Nicole Carvalho Xavier Micheloni da; Mendes, Carolina da Costa; Oliveira, Cora Pichler de; Bastos, Leonardo Soares; Cardoso, Claudete Aparecida Araújo

    2014-04-01

    This study aims to evaluate antiretroviral therapy in children and adolescents with AIDS. We selected 247 abstracts published from 1983 to 2013, collected from the PubMed and LILACS databases. Sixty-nine articles were selected. Attention to research in the pediatric age bracket in 30 years of the epidemic is explained by the age group's immunological characteristics, since AIDS progresses faster in children than in adults. Recent studies focus on the initiation of highly active antiretroviral therapy before the onset of symptoms. Early introduction of combination antiretroviral therapy has been implemented effectively and safely in populations with limited resources, leading to significantly improved survival. The current challenge is to manage a chronic disease with acute complications. New studies should focus on population specificities and identify the individual needs of pediatric patients.

  17. Multimodal physical therapy management of a 48-year-old female with post-stroke complex regional pain syndrome.

    Science.gov (United States)

    Anandkumar, Sudarshan; Manivasagam, Murugavel

    2014-01-01

    This case report describes a 48-year-old female who presented with complaints of right shoulder pain, hyperesthesias and swelling of the hand along with added symptoms of pain centralization following a cerebrovascular accident. On clinical evaluation, the patient satisfied the Budapest diagnostic criteria for Complex Regional Pain Syndrome (CRPS) type-1. Physical therapy management (1st three sessions) was initially focused on pain neurophysiology education with an aim to reduce kinesiophobia and reconceptualise her pain perception. The patient had an immediate significant improvement in her pain and functional status. Following this, pain modulation in the form of transcutaneous electrical nerve stimulation, kinesio tape application, "pain exposure" physical therapy and exercise therapy was carried out for a period of 7 weeks. The patient had complete resolution of her symptoms which was maintained at a six-month follow-up.

  18. Anxiety and Depression in Tinnitus Patients: 5-Year Follow-Up Assessment after Completion of Habituation Therapy

    Directory of Open Access Journals (Sweden)

    Eva-Signe Falkenberg

    2012-01-01

    Full Text Available Treatment programs based on a neurophysiological model have shown a positive effect on anxiety and depression in tinnitus patients. The aim of this paper was to assess the long-term effect of tinnitus habituation therapy. Sixty-eight individuals were treated with a comprehensive therapy program. The degree of anxiety and depression was assessed before, after, and five years after intervention using the Hospital Anxiety and Depression Scale. The positive and significant changes achieved after habituation therapy (pre = 1.10, post = 0.92 for anxiety and pre = 0.77, post = 0.62 for depression were maintained five years after treatment ended (0.87 for anxiety and 0.52 for depression. A regression analysis revealed that individual evaluation of the treatment lectures, self-reported health condition, individual experiences of hyperacusis, and hearing loss could explain 44.3% of the variation in anxiety and 30.5% of the variation in depression posttreatment. Five years after, individual evaluation of the treatment lectures and self-reported health condition explained 22.2% of the variation in anxiety. These factors and individual experiences of hyperacusis could further explain 34.9% of the variation in depression. The effect of a neurophysiologic-based management treatment was maintained five years after treatment ended, indicating that the patients continued the improvement process without becoming dependent on professionals.

  19. Anxiety and depression in tinnitus patients: 5-year follow-up assessment after completion of habituation therapy.

    Science.gov (United States)

    Falkenberg, Eva-Signe; Wie, Ona Bø

    2012-01-01

    Treatment programs based on a neurophysiological model have shown a positive effect on anxiety and depression in tinnitus patients. The aim of this paper was to assess the long-term effect of tinnitus habituation therapy. Sixty-eight individuals were treated with a comprehensive therapy program. The degree of anxiety and depression was assessed before, after, and five years after intervention using the Hospital Anxiety and Depression Scale. The positive and significant changes achieved after habituation therapy (pre = 1.10, post = 0.92 for anxiety and pre = 0.77, post = 0.62 for depression) were maintained five years after treatment ended (0.87 for anxiety and 0.52 for depression). A regression analysis revealed that individual evaluation of the treatment lectures, self-reported health condition, individual experiences of hyperacusis, and hearing loss could explain 44.3% of the variation in anxiety and 30.5% of the variation in depression posttreatment. Five years after, individual evaluation of the treatment lectures and self-reported health condition explained 22.2% of the variation in anxiety. These factors and individual experiences of hyperacusis could further explain 34.9% of the variation in depression. The effect of a neurophysiologic-based management treatment was maintained five years after treatment ended, indicating that the patients continued the improvement process without becoming dependent on professionals.

  20. Anthroposophic therapy for asthma: A two-year prospective cohort study in routine outpatient settings

    Directory of Open Access Journals (Sweden)

    Harald J Hamre

    2009-11-01

    Full Text Available Harald J Hamre1, Claudia M Witt2, Gunver S Kienle1, Christof Schnürer3, Anja Glockmann1, Renatus Ziegler4, Stefan N Willich2, Helmut Kiene11Institute for Applied Epistemology and Medical Methodology, Freiburg, Germany; 2Institute of Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany; 3Internal Medicine Practice, A Fraenkel Centrum, Badenweiler, Germany; 4Society for Cancer Research, Arlesheim, SwitzerlandBackground: Anthroposophic treatment for asthma includes special artistic and physical therapies and special medications.Methods: We studied consecutive outpatients starting anthroposophic treatment for asthma under routine conditions in Germany. Main outcomes were average asthma severity (0–10, primary outcome; symptoms (1–4; and asthma-related quality of life at 12-month follow-up (Asthma Quality of Life Questionnaire [AQLQ] overall score, 1–7, for adults; KINDL Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, asthma module, 0–100, for children at 12-month follow-up.Results: Ninety patients (54 adults, 36 children were included. Anthroposophic treatment modalities used were medications (88% of patients, n = 79/90; eurythmy therapy (22%; art therapy (10%; and rhythmical massage therapy (1%. Median number of eurythmy/art/massage sessions was 12 (interquartile range 10–20, median therapy duration was 120 days (84–184. From baseline to 12-month follow-up, all outcomes improved significantly (P < 0.001 for all comparisons. Average improvements were: average asthma severity 2.61 points (95% confidence interval CI: 1.90–3.32; cough 0.93 (95% CI: 0.60–1.25; dyspnea 0.92 (95% CI: 0.56–1.28; exertion-induced symptoms 0.95 (95% CI: 0.64–1.25; frequency of asthma attacks 0.78 (95% CI:0.41–1.14; awakening from asthma 0.90 (95% CI: 0.58–1.21; AQLQ overall score 1.44 (95% CI:0.97–1.92; and KINDL asthma module 14.74 (95% CI: 9.70–19

  1. Conservative medical therapy of prosthetic joint infections: retrospective analysis of an 8-year experience.

    Science.gov (United States)

    Pavoni, G L; Giannella, M; Falcone, M; Scorzolini, L; Liberatore, M; Carlesimo, B; Serra, P; Venditti, M

    2004-09-01

    Successful treatment of prosthetic joint infections often requires multiple surgical interventions and prolonged antimicrobial therapy. However, in certain situations, a surgical approach may not be in the best interest of the patient. A conservative approach was used to treat 34 patients with prosthetic joint infection between 1995 and 2003. Diagnosis of infection was based on clinical-microbiological evidence, confirmed by (99)Tc-labelled leukocyte scintigraphy, and involved 12 Staphylococcus aureus infections, nine Staphylococcus epidermidis infections, two Enterococcus faecalis infections, two mixed infections (S. aureus plus Pseudomonas aeruginosa; S. epidermidis plus E. faecalis), with the infecting pathogen being unidentified for nine patients. Most infections were treated initially with intravenous or intramuscular teicoplanin +/- ciprofloxacin or rifampicin, followed by oral ciprofloxacin or minocycline plus rifampicin. The mean duration of antimicrobial therapy was 41.2 weeks. Overall, only three patients did not respond to therapy, and infection was controlled in the remaining 31 patients. Among these, no relapse was observed in 17 patients during follow-up for 9-57 months; improvement with early (within 6 months of antibiotic discontinuation) or late relapse was observed in seven and three patients, respectively; two patients improved clinically, but continued to receive antibiotic therapy; and two patients whose condition improved initially were lost after a 6-month follow-up following discontinuation of antibiotics. No patient complained of side effects requiring discontinuation of antibiotic therapy. The study confirmed that suppression of infection, with salvage of the infected device in an acceptably functional state, can be achieved in selected cases.

  2. Noonan syndrome and Turner syndrome patients respond similarly to 4 years' growth-hormone therapy

    DEFF Research Database (Denmark)

    Lee, Peter A; Ross, Judith L; Pedersen, Birgitte Tønnes;

    2015-01-01

    BACKGROUND: Turner syndrome (TS) and Noonan syndrome (NS) are distinct syndromes associated with short stature and other similar phenotypic features. We compared the responses to growth hormone (GH) therapy of TS and NS patients enrolled in the NordiNet® International Outcome Study (IOS) or the A......BACKGROUND: Turner syndrome (TS) and Noonan syndrome (NS) are distinct syndromes associated with short stature and other similar phenotypic features. We compared the responses to growth hormone (GH) therapy of TS and NS patients enrolled in the NordiNet® International Outcome Study (IOS...

  3. L-Phenylalanine preloading reduces the (10)B(n, α)(7)Li dose to the normal brain by inhibiting the uptake of boronophenylalanine in boron neutron capture therapy for brain tumours.

    Science.gov (United States)

    Watanabe, Tsubasa; Tanaka, Hiroki; Fukutani, Satoshi; Suzuki, Minoru; Hiraoka, Masahiro; Ono, Koji

    2016-01-01

    Boron neutron capture therapy (BNCT) is a cellular-level particle radiation therapy that combines the selective delivery of boron compounds to tumour tissue with neutron irradiation. Previously, high doses of one of the boron compounds used for BNCT, L-BPA, were found to reduce the boron-derived irradiation dose to the central nervous system. However, injection with a high dose of L-BPA is not feasible in clinical settings. We aimed to find an alternative method to improve the therapeutic efficacy of this therapy. We examined the effects of oral preloading with various analogues of L-BPA in a xenograft tumour model and found that high-dose L-phenylalanine reduced the accumulation of L-BPA in the normal brain relative to tumour tissue. As a result, the maximum irradiation dose in the normal brain was 19.2% lower in the L-phenylalanine group relative to the control group. This study provides a simple strategy to improve the therapeutic efficacy of conventional boron compounds for BNCT for brain tumours and the possibility to widen the indication of BNCT to various kinds of other tumours.

  4. Additional studies on side effects of melperone in long-term therapy for 1 to 15 years in psychiatric patients.

    Science.gov (United States)

    Kirkegaard, A; Kirkegaard, G; Geismar, L; Christensen, I

    1981-01-01

    The present study which reports on the hitherto longest continuous melperone treatment recorded in the literature, was conducted in order to reveal side effects of long-term melperone therapy. 17 female and 20 male patients, aged 33-97 years, most of them with the diagnoses: schizophrenia (11 patients), dementia organica (11 patients) and dementia senilis (11 patients) were treated with melperone (Buronil) in doses of 15--800 mg/day for 1 to 15 years. The patients were examined for clinical side effects, abnormal electrocardiograms and ophthalmological diseases as well as abnormal values in sedimentation rate, hemoglobin, leucocytes, creatinine, alanine-aminotransferase, gamma-glutamyl-transferase and bilirubin. Also the thymol reaction was done. The electrocardiograms and laboratory investigations were controlled by specialists in internal medicine and the eye diseases by an ophthalmologist. We did not find any severe side effects which could be related with any certainty to melperone therapy.

  5. Results of a Second Year of Therapy with the 12-Month Histrelin Implant for the Treatment of Central Precocious Puberty

    Directory of Open Access Journals (Sweden)

    Shulman Dorothy

    2009-02-01

    Full Text Available Background. Gonadotropin releasing hormone analogs (GnRHas are standard of care for central precocious puberty (CPP. The histrelin subcutaneous implant is safe and effective in the treatment of CPP for one year. Objective. The study evaluates a second year of therapy in children with CPP who received a new implant after one year of treatment. Methods. A prospective one-year study following an initial 12-month treatment period was conducted. Results. Thirty-one patients (29 girls aged years received a second implant. Eighteen were naïve to GnRHa therapy at first implantation. Peak LH declined from  mIU/mL at 12 months to  mIU/mL at 24 months ( mIU/mL at 12 months to  mIU/mL at 24 months ( in previously treated subjects. Predicted adult height increased by 5.1 cm at 24 months (. Minor implant site reactions occurred in 61%, while minor difficulties with explantation occurred in 32.2% of subjects. Conclusion. The histrelin implant demonstrates profound hypothalamic-pituitary-gonadal axis suppression when a new implant is placed for a second year of treatment. Prospective follow-up of this therapeutic modality for the treatment of CPP is needed.

  6. The use of central laboratories and remote electronic data capture to risk-adjust therapy for pediatric acute lymphoblastic leukemia and neuroblastoma

    OpenAIRE

    Devidas, Meenakshi; London, Wendy B.; Anderson, James R.

    2010-01-01

    The Children’s Oncology Group (COG) is a National Cancer Institute sponsored cooperative clinical trials group with the primary mission of conducting pediatric cancer clinical trials. COG has complex risk classification systems that are used to deliver risk-stratified therapy for many pediatric cances, including clinical trials for Acute Lymphoblastic Leukemia (ALL) and Neuroblastoma (NB). Classification of patients is based on biological, clinical, and genomic data obtained at initial diagno...

  7. A case of catatonia in a 14-year-old girl with schizophrenia treated with electroconvulsive therapy.

    Science.gov (United States)

    Häßler, Frank; Reis, Olaf; Weirich, Steffen; Höppner, Jacqueline; Pohl, Birgit; Buchmann, Johannes

    2013-01-01

    This article presents a case of a 14-year-old female twin with schizophrenia who developed severe catatonia following treatment with olanzapine. Under a combined treatment with amantadine, electroconvulsive therapy (ECT), and (currently) ziprasidone alone she improved markedly. Severity and course of catatonia including treatment response were evaluated with the Bush-Francis Catatonia Rating Scale (BFCRS). This case report emphasizes the benefit of ECT in the treatment of catatonic symptoms in an adolescent patient with schizophrenic illness.

  8. Long-term observation of adolescents initiating HAART therapy : Three-year follow-up

    NARCIS (Netherlands)

    Flynn, Patricia M.; Rudy, Bret J.; Lindsey, Jane C.; Douglas, Steven D.; Lathey, Janet; Spector, Stephen A.; Martinez, Jaime; Silio, Margarita; Belzer, Marvin; Friedman, Lawrence; D'Angelo, Lawrence; Smith, Elizabeth; Hodge, Janice; Hughes, Michael D.

    2007-01-01

    The PACTG 381 cohort included 120 adolescents infected via high-risk behaviors and treated with at least two NRTIs plus either a protease inhibitor or an efavirenz-containing HAART regimen. After 24 weeks of therapy, only 69 of 118 (59%) evaluable subjects had undetectable viral loads. We now presen

  9. Pelvic Floor Stimulation Therapy Market: Future market projections for forthcoming years

    OpenAIRE

    Smita Deshmukh

    2016-01-01

    Transparency Market Research Reports incorporated a definite business overview and investigation inclines on "Pelvic Floor Stimulation Therapy Market". This report likewise incorporates more illumination about fundamental review of the business including definitions, requisitions and worldwide business sector industry structure.   Read Full Report: http://www.transparencymarketresearch.com/pelvic-floor-stimulation-devices-market.html

  10. Virtual Reality Cognitive-Behavior Therapy for Public Speaking Anxiety: One-Year Follow-up

    Science.gov (United States)

    Safir, Marilyn P.; Wallach, Helene S.; Bar-Zvi, Margalit

    2012-01-01

    Public speaking anxiety (PSA) is a common social phobia. Although cognitive-behavior therapy (CBT) is the treatment of choice, difficulties arise with both in vivo and in vitro exposure (lack of therapist control, patient's inability to imagine, self-flooding, and a lack of confidentiality resulting from public exposure). Virtual reality CBT…

  11. Infliximab therapy for moderately severe Crohn’s disease and ulcerative colitis: a retrospective comparison over 6 years

    Directory of Open Access Journals (Sweden)

    Raed Alzafiri

    2011-01-01

    Full Text Available Raed Alzafiri1, Christina A Holcroft2, Paula Malolepszy1, Albert Cohen1, Andrew Szilagyi11Jewish General Hospital, Division of Gastroenterology, Department of Medicine, McGill University School of Medicine, Montreal, Quebec, Canada; 2Centre for Clinical Epidemiology and Community Studies, McGill University School of Medicine, Montreal, Quebec, CanadaBackground: Infliximab has shown benefit in Crohn’s disease (CD and ulcerative colitis (UC.Objective: Evaluation of long-term outcome of therapy for both diseases.Methods: We analyzed retrospectively patients treated at infusion centers from one institution. Demographic, laboratory parameters leading up to biologic therapy and the subsequent pattern of outcomes in either disease were established as a database. Initial failure, subsequent need to change therapy, or need to adjust therapy were evaluated. Kruskal–Wallis (nonparametric tests to compare two groups and Kaplan–Meier survival curve analysis were used to compare outcomes.Results: Over approximately 6 years, 71 CD and 26 UC patients received 999 and 215 infusions, respectively, for a median of 62 months. Of these, 17% for CD and 19% for UC patients were primary failures. Following the start of infliximab, 18% of CD and 11% of UC patients required stoppage and switching to another type of therapy. In either CD or UC patients, 54% or 62%, respectively, continued therapy without the need to change to other treatments. Few serious side effects were noted. No important statistically significant differences in treatment patterns or outcome were observed between the groups.Discussion: Long-term treatment of both inflammatory bowel diseases reflects outcomes of clinical trials.Conclusions: This study emphasizes similarities between CD and UC and reports therapeutic success for an extended time.Keywords: infliximab, inflammatory bowel diseases

  12. 20 years experience in radiobiology of neutron, and 10 years experience of neutron therapy in Obninsk, Russia. (Neutrons against cancer - the new methods in radiation therapy of tumors using nuclear reactor neutron beams)

    Energy Technology Data Exchange (ETDEWEB)

    Mardinsky, Y.S.; Oulianenko, S.E.; Obaturov, G.M. [Medical Radiological Research Center of Russian Academy of Medical Sciences, Obninsk (Russian Federation)] [and others

    1997-12-31

    New technology of radiation therapy, developed in Obninsk, is based on newly acquired knowledge in biological effects of neutrons. Detailed studies have been made of antitumor effectiveness of neutrons and of radiomodification factors action. Up till now more then 250 patients with tumors have been treated using reactor neutrons. Integral analysis of 5-year survival rates indicated a higher efficiency of neutron and mixed gamma-neutron therapy as compared with conventional radiation treatment. The survival rates were 89% for larynx cancer and 67% for breast cancer after neutron irradiation; the corresponding values were 65% and 46% after conventional radiation. The advantages of neutrons have been demonstrated both in loco-regional control and in overcoming of recurrences and metastasis

  13. [Thirty years of Met receptor research: from the discovery of an oncogene to the development of targeted therapies].

    Science.gov (United States)

    Montagne, Rémi; Furlan, Alessandro; Kherrouche, Zoulika; Tulasne, David

    2014-10-01

    In 1984, the Met receptor and its ligand, the HGF/SF, were discovered thanks to their ability to induce cell transformation and proliferation. Thirty years of research highlighted their crucial role in the development and homeostasis of various structures, including many epithelial organs. This period also allowed unraveling the structural basis of their interaction and their complex signaling network. In parallel, Met was shown to be deregulated and associated with a poor prognosis in many cancers. Met involvement in resistance to current therapies is also being deciphered. Based on these data, pharmaceutical companies developed a variety of Met inhibitors, some of which are evaluated in phase III clinical trials. In this review, we trace the exemplary track record of research on Met receptor, which allowed moving from bench to bedside through the development of therapies targeting its activity. Many questions still remain unanswered such as the involvement of Met in several processes of development, the mechanisms involving Met in resistance to current therapies or the likely emergence of resistances to Met-targeted therapies.

  14. Comparison of outcomes twelve years after antireflux surgery or omeprazole maintenance therapy for reflux esophagitis

    DEFF Research Database (Denmark)

    Lundell, Lars; Miettinen, Pekka; Myrvold, Helge E

    2009-01-01

    . Heartburn and regurgitation were significantly more common in patients given omeprazole, whereas dysphagia, rectal flatulence, and the inability to belch or vomit were significantly more common in surgical patients. The therapies were otherwise well-tolerated. CONCLUSIONS: As long-term therapeutic...... strategies for chronic GERD, surgery and omeprazole are effective and well-tolerated. Antireflux surgery is superior to omeprazole in controlling overall disease manifestations, but post-fundoplication complaints continue after surgery....

  15. A 10-Year Retrospective Analysis of Methyl Aminolevulinate Photodynamic Therapy Consultation at the Hospital de Braga

    OpenAIRE

    Brito, C; Resende, C.; Oliveira, P.

    2016-01-01

    Introduction Photodynamic therapy (PDT) is a well-established treatment for actinic keratosis (AK), basal cell carcinoma (BCC), and Bowen’s disease (BD). The object of this study was to describe the results of a retrospective analysis of patients treated with methyl aminolevulinate PDT (MAL-PDT) with red light, over the past decade at the Hospital de Braga (Braga, Portugal). Methods This study is based on the retrospective analysis of the clinical records of patients treated with MAL-PDT from...

  16. Five-year comparative study on conventional and laser-assisted therapy of periimplantitis and periodontitis

    Science.gov (United States)

    Bach, Georg; Neckel, Claus P.

    2000-03-01

    Numerous groups have recommended the use of the diode laser to decontaminate infected root and implant surfaces. The aim of this study was to show the outcome after laser assisted and conventional therapy of periimplantitis and periodontitis administering approved treatment protocols. Between 1994 and 1999 a total of 50 patients with periimplantitis (20) and periodontitis (30) were treated in two groups each. Clinical, microbiological and radiographic evaluation was performed before and 6, 12, 24, 36, 48 and 60 months after treatment. In addition to the conventional treatment protocol, flap surgery, the tooth or implant surface was decontaminated with a 810 nm diode laser using 1 Watt output for 20 sec (CW mode). All accessible surfaces were decontaminated at the follow up dates. In the periimplantitis group recurrence of the marker bacteria was higher and faster over time for the conventionally operated patients. Also the clinical and radiographic reevaluation showed significantly better results. The laser group of the periodontitis patients also showed significantly better outcome in terms of clinical evaluation, microbiological counts, radiographic evaluation and tooth loss. In comparison to other long term studies our results for the conventional therapy were adequate, the laser assisted therapy brought up significantly better and reproducible results.

  17. Anthroposophic therapy for attention deficit hyperactivity: A two-year prospective study in outpatients

    Directory of Open Access Journals (Sweden)

    Harald J Hamre

    2010-08-01

    Full Text Available Harald J Hamre1, Claudia M Witt2, Gunver S Kienle1, Christoph Meinecke3, Anja Glockmann1, Renatus Ziegler4, Stefan N Willich2, Helmut Kiene11Institute for Applied Epistemology and Medical Methodology, Freiburg, Germany; 2Institute of Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany; 3Pediatric Consultant, Community Hospital Havelhöhe, Berlin, Germany; 4Society for Cancer Research, Arlesheim, SwitzerlandBackground: Anthroposophic treatment for attention deficit hyperactivity disorder (ADHD includes special artistic and physical therapies and special medications.Methods: We studied 61 consecutive children starting anthroposophic treatment for ADHD symptoms under routine outpatient conditions. Primary outcome was FBB-HKS (a parents’ questionnaire for ADHD core symptoms, 0–3, and secondary outcomes were disease and symptom scores (physicians’ and parents’ assessment, 0–10 and quality of life (KINDL® total score, 0–100.Results: A total of 67% of patients fulfilled the DSM-IV criteria for ADHD, 15% had an exclusion diagnosis such as pervasive developmental disorders, while 18% did not fulfill ADHD criteria for another reason. Anthroposophic treatment modalities used were eurythmy therapy (in 56% of patients, art therapy (20%, rhythmical massage therapy (8%, and medications (51%. From baseline to six-month follow-up, all outcomes improved significantly; average improvements were FBB-HKS total score 0.30 points (95% confidence interval [CI]: 0.18–0.43; P < 0.001, FBB-HKS inattention 0.36 (95% CI: 0.21–0.50; P < 0.001, FBB-HKS hyperactivity 0.29 (95% CI: 0.14–0.44; P < 0.001, FBB-HKS impulsivity 0.22 (95% CI: 0.03–0.40; P < 0.001, disease score 2.33 (95% CI: 1.84–2.82; P < 0.001, symptom score 1.66 (95% CI: 1.17–2.16; P < 0.001, and KINDL 5.37 (95% CI: 2.27–8.47; P = 0.001. Improvements were similar in patients not using stimulants (90% of patients at months 0–6 and

  18. Persistence of lipoatrophy after a four-year long interruption of antiretroviral therapy for HIV1 infection: case report

    Directory of Open Access Journals (Sweden)

    Toro Giuseppe

    2005-10-01

    Full Text Available Abstract Background HIV-infected patients on long-term highly active antiretroviral therapy often present peculiar patterns of fat redistribution, referred to as lipodystrophy. In spite of recent investigations, it is not known whether and to what extent the main features of lipodystrophy – that is lipoatrophy of peripheral fat at face, limbs and buttocks, as well as fat accumulation at breasts, abdomen and the dorso-cervical region – can be reversible once clinically manifest. Case presentation A 35 year old Caucasian HIV infected female developed severe diffuse lipodystrophy while on highly active antiretroviral therapy. A remarkable increase of breast size, fat accumulation at waist, and a fat pad on her lumbar spine were paralleled by progressive and disfiguring lipoatrophy of face, limbs and buttocks. The patient decided to interrupt her therapy after 20 months, with a stably suppressed viremia and a CD4 lymphocyte count >500/μL. She could carry on a safe treatment interruption for longer than 4 years. Most sites of fat accumulation switched to nearly normal appearance, whereas lipoatrophy was substantially unchanged at all affected sites. Conclusion our observation provides pictorial evidence that lipoatrophy may not be reversible even under ideal circumstances. Therefore, strategies to prevent lipoatrophy should be considered when defining therapeutic regimens for HIV infected patients, especially those at high risk.

  19. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival : an overview of the randomised trials

    NARCIS (Netherlands)

    Abe, O; Abe, R; Enomoto, K; Kikuchi, K; Koyama, H; Masuda, H; Nomura, Y; Sakai, K; Sugimachi, K; Tominaga, T; Uchino, J; Yoshida, M; Haybittle, JL; Davies, C; Harvey, VJ; Holdaway, TM; Kay, RG; Mason, BH; Forbes, JF; Wilcken, N; Gnant, M; Jakesz, R; Ploner, M; Yosef, HMA; Focan, C; Lobelle, JP; Peek, U; Oates, GD; Powell, J; Durand, M; Mauriac, L; Di Leo, A; Dolci, S; Piccart, MJ; Masood, MB; Parker, D; Price, JJ; Hupperets, PSGJ; Jackson, S; Ragaz, J; Berry, D; Broadwater, G; Cirrincione, C; Muss, H; Norton, L; Weiss, RB; Abu-Zahra, HT; Portnoj, SM; Baum, M; Cuzick, J; Houghton, J; Riley, D; Gordon, NH; Davis, HL; Beatrice, A; Mihura, J; Naja, A; Lehingue, Y; Romestaing, P; Dubois, JB; Delozier, T; Mace-Lesec'h, J; Rambert, P; Andrysek, O; Barkmanova, J; Owen, [No Value; Meier, P; Howell, A; Ribeiro, GC; Swindell, R; Alison, R; Boreham, J; Clarke, M; Collins, R; Darby, S; Davies, C; Elphinstone, P; Evans, [No Value; Godwin, J; Gray, R; Harwood, C; Hicks, C; James, S; MacKinnon, E; McGale, P; McHugh, T; Mead, G; Peto, R; Wang, Y; Albano, J; de Oliveira, CF; Gervasio, H; Gordilho, J; Johansen, H; Mouridsen, HT; Gelman, RS; Harris, [No Value; Henderson, IC; Shapiro, CL; Andersen, KW; Axelsson, CK; Blichert-Toft, M; Moller, S; Mouridsen, HT; Overgaard, J; Overgaard, M; Rose, C; Cartensen, B; Palshof, T; Trampisch, HJ; Dalesio, O; de Vries, EGE; Rodenhuis, S; van Tinteren, H; Comis, RL; Davidson, NE; Gray, R; Robert, N; Sledge, G; Tormey, DC; Wood, W; Cameron, D; Chetty, U; Forrest, P; Jack, W; Rossbach, J; Klijn, JGM; Treurniet-Donker, AD; van Putten, WLJ; Costa, A; Veronesi, U; Bartelink, H; Duchateau, L; Legrand, C; Sylvester, R; van der Hage, JA; van de Velde, CJH; Cunningham, MP; Catalano, R; Creech, RH; Bonneterre, J; Fargeot, P; Fumoleau, P; Kerbrat, P; Namer, M; Jonat, W; Kaufmann, M; Schumacher, M; von Minckwitz, G; Bastert, G; Rauschecker, H; Sauer, R; Sauerbrei, W; Schauer, A; Schumacher, M; de Schryver, A; Vakaet, L; Belfiglio, M; Nicolucci, A; Pellegrini, F; Sacco, M; Valentini, M; McArdle, CS; Smith, DC; Galligioni, E; Boccardo, F; Rubagotti, A; Dent, DM; Gudgeon, CA; Hacking, A; Erazo, A; Medina, JY; Izuo, M; Morishita, Y; Takei, H; Fentiman, IS; Hayward, JL; Rubens, RD; Skilton, D; Graeff, H; Janicke, F; Meisner, C; Scheurlen, H; Kaufmann, M; von Fournier, D; Dafni, U; Fountzilas, G; Klefstrom, P; Blomqvist, C; Saarto, T; Margreiter, R; Asselain, B; Salmon, RJ; Vilcoq, [No Value; Arriagada, R; Hill, C; Laplanche, A; Le, MG; Spielmann, M; Bruzzi, P; Montanaro, E; Rosso, R; Sertoli, MR; Venturini, M; Amadori, D; Benraadt, J; Kooi, M; van de Velde, AO; van Dongen, JA; Vermorken, JB; Castiglione, M; Cavalli, F; Coates, A; Collins, J; Forbes, J; Gelber, RD; Goldhirsch, A; Lindtner, J; Price, KN; Rudenstam, CM; Senn, HJ; Bliss, JM; Chilvers, CED; Coombes, RC; Hall, E; Marty, M; Borovik, R; Brufman, G; Hayat, H; Robinson, E; Wigler, N; Bonadonna, G; Camerini, T; De Palo, G; Del Vecchio, M; Formelli, F; Valagussa, P; Martoni, A; Pannuti, F; Cocconi, G; Colozza, A; Camisa, R; Aogi, K; Takashima, S; Abe, O; Ikeda, T; Inokuchi, K; Kikuchi, K; Sawa, K; Sonoo, H; Korzeniowski, S; Skolyszewski, J; Ogawa, M; Yamashita, J; Bonte, J; Christiaens, R; Paridaens, R; Van den Boegart, W; Martin, P; Romain, S; Hakes, T; Hudis, CA; Norton, L; Wittes, R; Giokas, G; Kondylis, D; Lissaios, B; de la Huerta, R; Sainz, MG; Altemus, R; Cowan, K; Danforth, D; Lichter, A; Lippman, M; O'Shaughnessy, J; Pierce, LJ; Steinberg, S; Venzon, D; Zujewski, J; Paradiso, A; De Lena, M; Schittulli, F; Myles, JD; Pater, JL; Pritchard, KI; Nomura, Y; Anderson, S; Bass, G; Brown, A; Bryant, J; Costantino, J; Dignam, J; Fisher, B; Redmond, C; Wieand, S; Wolmark, N; Baum, M; Jackson, IM; Palmer, MK; Ingle, JN; Suman, VJ; Bengtsson, NO; Jonsson, H; Larsson, LG; Lythgoe, JP; Swindell, R; Kissin, M; Erikstein, B; Hannisdal, E; Jacobsen, AB; Varhaug, JE; Erikstein, B; Gundersen, S; Hauer-Jensen, M; Host, H; Jacobsen, AB; Nissen-Meyer, R; Blamey, RW; Mitchell, AK; Morgan, DAL; Robertson, JFR; Di Palma, M; Mathe, G; Misset, JL; Clark, RM; Levine, M; Morimoto, K; Sawa, K; Takatsuka, Y; Crossley, E; Harris, A; Talbot, D; Taylor, M; Cocconi, G; di Blasio, B; Ivanov, [No Value; Semiglazov, [No Value; Brockschmidt, J; Cooper, MR; Ueo, H; Falkson, CI; A'Hern, R; Ashley, S; Powles, TJ; Smith, IE; Yarnold, [No Value; Gazet, JC; Cocoran, N; Deshpande, N; di Martino, L; Douglas, P; Hacking, A; Host, H; Lindtner, A; Notter, G; Bryant, AJS; Ewing, GH; Firth, LA; Krushen-Kosloski, JL; Nissen-Meyer, R; Foster, L; George, WD; Stewart, HJ; Stroner, P; Malmstrom, P; Moller, TR; Ryden, S; Tengrup, [No Value; Tennvall-Nittby, L; Carstenssen, J; Dufmats, M; Hatschek, T; Nordenskjold, B; Soderberg, M; Carpenter, JT; Albain, K; Crowley, J; Green, S; Martino, S; Osborne, CK; Ravdin, PM; Glas, U; Johansson, U; Rutqvist, LE; Singnomklao, T; Wallgren, A; Castiglione, M; Goldhirsch, A; Maibach, R; Senn, HJ; Thurlimann, B; Brenner, H; Hercbergs, A; Yoshimoto, M; DeBoer, G; Paterson, AHG; Pritchard, KI; Meakin, JW; Panzarella, T; Pritchard, KI; Shan, Y; Shao, YF; Wang, [No Value; Zhao, DB; Boreham, J; Chen, ZM; Pan, HC; Peto, R; Bahi, J; Reid, M; Spittle, M; Deutsch, GP; Senanayake, F; Kwong, DLW; Bianco, AR; Carlomagno, C; De Laurentiis, M; De Placido, S; Buzdar, AU; Smith, T; Bergh, J; Holmberg, L; Liljegren, G; Nilsson, J; Seifert, M; Sevelda, P; Zielinsky, CC; Buchanan, RB; Cross, M; Royle, GT; Dunn, JA; Hills, RK; Lee, M; Morrison, JM; Spooner, D; Litton, A; Chlebowski, RT; Caffier, H

    2005-01-01

    Background Quinquennial overviews (1985-2000) of the randomised trials in early breast cancer have assessed the 5-year and 10-year effects of various systemic adjuvant therapies on breast cancer recurrence and survival. Here, we report the 10-year and 15-year effects. Methods Collaborative meta-anal

  20. The effect of hormone therapy on women's quality of life in the first year of the Estonian Postmenopausal Hormone Therapy trial

    Directory of Open Access Journals (Sweden)

    Veerus Piret

    2012-04-01

    Full Text Available Abstract Background For postmenopausal women, the main reason to start hormone therapy (HT is to reduce menopausal symptoms and to improve quality of life (QOL. The aim of this study was to analyse the impact of HT on different aspects of symptom experience and QOL during a randomised trial. A total of 1823 postmenopausal women were recruited into the Estonian Postmenopausal Hormone Therapy (EPHT trial in 1999–2001. Women were randomised to blind HT, open-label HT, placebo or non-treatment arm. After one year in the trial, a questionnaire was mailed and 1359 women (75% responded, 686 in the HT arms and 673 in the non-HT arms. Mean age at filling in the questionnaire was 59.8 years. The questionnaire included Women's Health Questionnaire (WHQ to assess menopause specific QOL of middle-aged women together with a 17-item questionnaire on symptoms related to menopause, a question about painful intercourse, and a question about women's self-rated health. Results After one year in the trial, fewer women in the HT arms reported hot flashes, trouble sleeping, and sweating on the symptom questionnaire. According to WHQ, women in the HT arms had fewer vasomotor symptoms, sleep problems, and problems with sexual behaviour, but more menstrual symptoms; HT had no effect on depression, somatic symptoms, memory, attractiveness, or anxiety. A smaller proportion of women reported painful intercourse in the HT arms. There were no significant differences between the trial arms in women’s self-rated subjective health. Conclusions The results from the EPHT trial confirm that HT is not justified for treating symptoms, other than vasomotor symptoms, among postmenopausal women. WHQ proved to be a useful and sensitive tool to assess QOL in this age group of women.

  1. [Cavity preparation and restorative therapy in articles, published by the Fogorvosi Szemle in the last hundred years].

    Science.gov (United States)

    Nemes, Júlia; Duhaj, Szilvia; Nyárasdy, Ida

    2009-04-01

    The aim of this review is to overview the development achieved in restorative therapy based on the publications in Fogorvosi Szemle during the past hundred years. The top quality of the restorative therapy was, and still has been the inlay, but nowadays the esthetic inlay -- fixed with adhesive material -- has priority over the gold inlay. The quality of amalgam fillings has been recently improved by using high-copper containing amalgam alloys. The development on the field of adhesive material and methods made it possible to give up the routine use of any conventional base material. The place of gingival wall of the cavity moved from subgingival position into supragingival position. The macro retention has been replaced by micro retention, and nowadays the cavity preparation prefers minimal-invasive techniques.

  2. 28-Year Survival following Several Metastasectomies, Going through 8th Line Systemic Therapy in a Case of mRCC.

    Science.gov (United States)

    Magdy, A; Bretterbauer, K; Hruby, S; Kunit, T; Colleselli, D; Janetschek, G; Mitterberger, M

    2015-01-01

    Metastatic renal cell carcinoma (mRCC) has been one of the most treatment-resistant cancers because of its unpredictable clinical course, resistance to chemo- and radiotherapy, and the limited response to immunotherapy and targeted agents. We present a case of long-term survival, that is, 28 years, after primary diagnosis (longest survival in the literature up to our knowledge) with mRCC after several metastasectomies (from local site recurrence, liver, and lung) and eight lines of systemic targeted therapy. This case report shows how crucial is the regular follow-up of patients with RCC after primary management and positive impact of early metastasectomy and systemic targeted therapy in case of mRCC on patients' condition and overall survival.

  3. Remission without insulin therapy on gluten-free diet in a 6-year old boy with type 1 diabetes mellitus

    DEFF Research Database (Denmark)

    Sildorf, Stine Møller; Fredheim, Siri; Svensson, Jannet

    2012-01-01

    A 5-year and 10-month old boy was diagnosed with classical type 1 diabetes mellitus (T1DM) without celiac disease. He started on a gluten-free diet after 2–3 week without need of insulin treatment. At the initiation of gluten-free diet, HbA1c was 7.8% and was stabilised at 5.8%–6.0% without insulin...... therapy. Fasting blood glucose was maintained at 4.0–5.0 mmol/l. At 16 months after diagnosis the fasting blood glucose was 4.1 mmol/l and after 20 months he is still without daily insulin therapy. There was no alteration in glutamic acid decarboxylase positivity. The gluten-free diet was safe and without...... side effects. The authors propose that the gluten-free diet has prolonged remission in this patient with T1DM and that further trials are indicated....

  4. Defense mechanisms after brief cognitive-behavior group therapy for panic disorder: one-year follow-up.

    Science.gov (United States)

    Heldt, Elizeth; Blaya, Carolina; Kipper, Leticia; Salum, Giovanni A; Otto, Michael W; Manfro, Gisele G

    2007-06-01

    Changes in defense mechanisms have been shown in long-term psychodynamic treatment. The aim of this study was to examine the changes that occurred after brief cognitive-behavior group therapy in the defense style of panic disorder patients that had failed to respond to pharmacotherapy. Forty-seven patients participated in the study and severity of panic disorder was evaluated by Clinical Global Impression. Defense mechanisms were evaluated by the Defense Style Questionnaire. Patients decreased the use of maladaptive defenses after cognitive-behavior group therapy, and the change in immature defenses was maintained at 1-year follow-up evaluation (p = 0.022). These modifications were associated with reduction of symptoms (F = 0.359; p = 0.047). These findings are consistent with the hypothesis that defense styles are malleable in short-term treatment and are, at least partially, symptom-state dependent.

  5. Vismodegib Therapy for Basal Cell Carcinoma in an 8-Year-Old Chinese Boy with Xeroderma Pigmentosum.

    Science.gov (United States)

    Fife, Douglas; Laitinen, Marko A; Myers, David J; Landsteiner, Pamela B

    2017-03-01

    Vismodegib is an oral inhibitor of the Hedgehog signaling pathway and has been used to treat basal cell carcinoma (BCC) in adults. This article reports clearance of a nodular BCC of the nasal tip in an 8-year-old boy with xeroderma pigmentosum (XP). BCC can pose therapeutic challenges when located in areas that are not amenable to traditional therapies such as Mohs micrographic surgery or topical agents. Vismodegib was used at a dose of 150 mg/day to treat the boy's BCC. After 4 months of therapy, we achieved complete clinical clearance. During 21 months of follow-up, the patient's nose remained clinically clear of tumor. Vismodegib was successfully used to treat a child with XP and nodular BCC. Our goal in using vismodegib was tumor regression while avoiding cosmetic and functional disfigurement. Vismodegib was effective in clinically clearing the tumor, and the patient has shown no signs of recurrence. Further studies are warranted.

  6. Boron neutron capture synovectomy (BNCS) as a potential therapy for rheumatoid arthritis: boron biodistribution study in a model of antigen-induced arthritis in rabbits.

    Science.gov (United States)

    Trivillin, Verónica A; Abramson, David B; Bumaguin, Gaston E; Bruno, Leandro J; Garabalino, Marcela A; Monti Hughes, Andrea; Heber, Elisa M; Feldman, Sara; Schwint, Amanda E

    2014-11-01

    Boron neutron capture synovectomy (BNCS) is explored for the treatment of rheumatoid arthritis (RA). The aim of the present study was to perform boron biodistribution studies in a model of antigen-induced arthritis (AIA) in female New Zealand rabbits, with the boron carriers boronophenylalanine (BPA) and sodium decahydrodecaborate (GB-10) to assess the potential feasibility of BNCS for RA. Rabbits in chronic phase of AIA were used for biodistribution studies employing the following protocols: intra-articular (ia) (a) BPA-f 0.14 M (0.7 mg (10)B), (b) GB-10 (5 mg (10)B), (c) GB-10 (50 mg (10)B) and intravenous (iv), (d) BPA-f 0.14 M (15.5 mg (10)B/kg), (e) GB-10 (50 mg (10)B/kg), and (f) BPA-f (15.5 mg (10)B/kg) + GB-10 (50 mg (10)B/kg). At different post-administration times (13-85 min for ia and 3 h for iv), samples of blood, pathological synovium (target tissue), cartilage, tendon, muscle, and skin were taken for boron measurement by inductively coupled plasma mass spectrometry. The intra-articular administration protocols at boron concentrations (>20 ppm) in the pathological synovium. Dosimetric estimations suggest that BNCS would be able to achieve a therapeutically useful dose in pathological synovium without exceeding the radiotolerance of normal tissues in the treatment volume, employing boron carriers approved for use in humans. Radiobiological in vivo studies will be necessary to determine the actual therapeutic efficacy of BNCS to treat RA in an experimental model.

  7. Basic research of boron neutron-capture therapy for treatment of pancreatic cancer. Application of neutron radiography for visualization of boron compound on BNCT

    Energy Technology Data Exchange (ETDEWEB)

    Yanagie, Hironobu [Tokyo Univ. (Japan). Inst. of Medical Science

    1997-02-01

    The cytotoxic effects of locally injected {sup 10}B-immunoliposomes (anti-CEA) on human pancreatic carcinoma xenografts in nude mice were evaluated with thermal neutron irradiation. After thermal neutron irradiation of mice injected with {sup 10}B-immunoliposomes, AsPC-1 tumour growth was suppressed relative to controls. Histopathologically, hyalinization and necrosis were found in {sup 10}B-treated tumours, while tumour tissue injected with saline or saline-containing immunoliposomes showed neither destruction nor necrosis. These results suggest that intratumoral injection of boronated immunoliposomes can increase the retention of {sup 10}B atoms by tumour cells, causing tumour growth suppression in vivo upon thermal neutron irradiation. We prepared boronated PEG-binding bovine serum albumin ({sup 10}B-PEG-BSA). {sup 10}B concentrations in AsPC-1, human pancreatic cancer cells (2 x 10{sup 5} /well) obtained 24 hrs after incubation with {sup 10}B-PEG-BSA was 13.01 {+-} 1.74 ppm. The number of {sup 10}B atoms delivered to the tumor cells was calculated to be 7.83 x 10{sup 11} at 24 hrs after incubation with {sup 10}B-PEG-BSA. These data indicated that the {sup 10}B-PEG-BSA could deliver a sufficient amount of {sup 10}B atoms (more than 10{sup 9} atoms/cell) to the tumor cells to induce cytotoxic effects after incubation upon thermal neutron irradiation. Neutron capture autoradiography by using an Imaging Plate (IP-NCR) was performed on AsPC-1 tumor-bearing mouse that had been given an intratumoral injection of {sup 10}B-PEG BSA or {sup 10}B-cationic liposome. We had demonstrated the {sup 10}B-PEG BSA or {sup 10}B-cationic liposome is taken up by AsPC-1 tumor tissue to a much greater extent than by normal tissues. (J.P.N.)

  8. Persistent Inflammation and Endothelial Activation in HIV-1 Infected Patients after 12 Years of Antiretroviral Therapy

    DEFF Research Database (Denmark)

    Rönsholt, Frederikke F; Ullum, Henrik; Katzenstein, Terese L;

    2013-01-01

    The study investigated markers of inflammation and endothelial activation in HIV infected patients after 12 years of successful combination antiretroviral treatment (cART).......The study investigated markers of inflammation and endothelial activation in HIV infected patients after 12 years of successful combination antiretroviral treatment (cART)....

  9. Results of a Second Year of Therapy with the 12-Month Histrelin Implant for the Treatment of Central Precocious Puberty

    Directory of Open Access Journals (Sweden)

    Samar Rahhal

    2009-01-01

    Full Text Available Background. Gonadotropin releasing hormone analogs (GnRHas are standard of care for central precocious puberty (CPP. The histrelin subcutaneous implant is safe and effective in the treatment of CPP for one year. Objective. The study evaluates a second year of therapy in children with CPP who received a new implant after one year of treatment. Methods. A prospective one-year study following an initial 12-month treatment period was conducted. Results. Thirty-one patients (29 girls aged 7.7±1.5 years received a second implant. Eighteen were naïve to GnRHa therapy at first implantation. Peak LH declined from 0.92±0.58 mIU/mL at 12 months to 0.51±0.33 mIU/mL at 24 months (P < .0001 in naïve subjects, and from 0.74±0.50 mIU/mL at 12 months to 0.45±0.35 mIU/mL at 24 months (P=.0081 in previously treated subjects. Predicted adult height increased by 5.1 cm at 24 months (P=.0001. Minor implant site reactions occurred in 61%, while minor difficulties with explantation occurred in 32.2% of subjects. Conclusion. The histrelin implant demonstrates profound hypothalamic-pituitary-gonadal axis suppression when a new implant is placed for a second year of treatment. Prospective follow-up of this therapeutic modality for the treatment of CPP is needed.

  10. A 5-Year Investigation of Children's Adaptive Functioning Following Conformal Radiation Therapy for Localized Ependymoma

    Energy Technology Data Exchange (ETDEWEB)

    Netson, Kelli L.; Conklin, Heather M. [Department of Psychology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Wu Shengjie; Xiong Xiaoping [Department of Biostatistics, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Merchant, Thomas E., E-mail: thomas.merchant@stjude.org [Division of Radiation Oncology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States)

    2012-09-01

    Purpose: Conformal and intensity modulated radiation therapies have the potential to preserve cognitive outcomes in children with ependymoma; however, functional behavior remains uninvestigated. This longitudinal investigation prospectively examined intelligence quotient (IQ) and adaptive functioning during the first 5 years after irradiation in children diagnosed with ependymoma. Methods and Materials: The study cohort consisted of 123 children with intracranial ependymoma. Mean age at irradiation was 4.60 years (95% confidence interval [CI], 3.85-5.35). Serial neurocognitive evaluations, including an age-appropriate IQ measure and the Vineland Adaptive Behavior Scales (VABS), were completed before irradiation, 6 months after treatment, and annually for 5 years. A total of 579 neurocognitive evaluations were included in these analyses. Results: Baseline IQ and VABS were below normative means (P<.05), although within the average range. Linear mixed models revealed stable IQ and VABS across the follow-up period, except for the VABS Communication Index, which declined significantly (P=.015). Annual change in IQ (-.04 points) did not correlate with annual change in VABS (-.90 to +.44 points). Clinical factors associated with poorer baseline performance (P<.05) included preirradiation chemotherapy, cerebrospinal fluid shunt placement, number and extent of surgical resections, and younger age at treatment. No clinical factors significantly affected the rate of change in scores. Conclusions: Conformal and intensity modulated radiation therapies provided relative sparing of functional outcomes including IQ and adaptive behaviors, even in very young children. Communication skills remained vulnerable and should be the target of preventive and rehabilitative interventions.

  11. Results of radiation therapy in stage 1B cervical carcinoma at King Chulalongkorn Memorial Hospital: fifteen-year experience.

    Science.gov (United States)

    Lertbutsayanukul, C; Lertsanguansinchai, P; Shotelersuk, K; Khorprasert, C; Rojpornpradit, P; Asavametha, N; Pataramontree, J; Suriyapee, S; Tresukosol, D; Termrungruanglert, W

    2001-06-01

    A retrospective study was performed on 131 patients with stage 1B cervical carcinoma who were referred and treated with external beam radiation and intracavitary brachytherapy at the Division of Radiation Therapy, Department of Radiology, King Chulalongkorn Memorial Hospital between February 1985 and February 2000. Primary outcomes were overall survival rate, progression free survival rate, recurrence, and treatment-related complications. The treatment results from different sources of intracavitary radiation therapy were secondary endpoints. The number of patients treated with Ra-226, Cs-137, and Ir-192 intracavitary irradiation were 12, 84, and 35 patients respectively. The median follow-up times were 69, 59, and 21 months for Ra-226, Cs-137, and Ir-192, respectively. Actuarial 5-year overall survival rate was 89 per cent. The 5-year progression free survival rate was 80 per cent. Actuarial 5-year survival and progression free survival rate were comparable among different sources of intracavitary brachytherapy (p = 0.553 and p=0.793, respectively). The overall recurrent rate was 16.8 per cent. Of the recurrence; 40.9 per cent was locoregional, 54.6 per cent was distant failure, and 4.5 per cent was combined locoregional and distant failure. The overall complication rate was 25.95 per cent. The severe complication rates (Grade III-V) from treatment occurred in the urinary bladder (0.76%) and in the small bowel (0.76%.) These results suggest that radiation therapy alone is an effective treatment for stage 1B cervical carcinoma. Additionally, all types of intracavitary brachytherapy provide comparable clinical results.

  12. Photodynamic therapy on spontaneous tumors of dogs and cats: a ten-year study

    Science.gov (United States)

    Fonda, Diego

    1992-06-01

    Since 1981, more than fifty spontaneous tumors of dogs and cats were treated by photodynamic therapy with hematoporphyrins in the surgery department of the University of Milan. Therapeutic results proved to be successful and promising in certain forms of cancer and will be compared in the future with the effectiveness of other photosensitizer drugs like phatolocyanines derivatives. Applied hematoporphyrins phototherapy methods included: (1) injection of hematoporphyrins derivative (HpD) and irradiation with laser light at 631 nanometers, using a Rhodamine B dye laser; (2) injection of the active component of hematoporphyrin derivative (DHE) and irradiation with a Rhodamine B dye laser; and (3) injection of DHE and irradiation with laser light at 628 nanometers using a gold vapor laser. More frequently treated tumor sites were oral and nasal cavities. Other localizations were mucous membranes of the glans and stomach. Nineteen histological types were diagnosed in treated tumors.

  13. CHANGES OF BONE MINERAL DENSITY DURING FOUR-YEAR RITUXIMAB AND METHOTREXATE THERAPY IN POSTMENOPAUSAL WOMEN WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    T. A. Raskina

    2016-01-01

    Full Text Available Objective: to estimate the changes of bone mineral density (BMD  at the femoral neck and lumbar spine during fouryear combination  therapy with rituximab (RTM  and methotrexate (MT in postmenopausal women with rheumatoid arthritis (RA.Subjects and methods. 79 postmenopausal women with a documented diagnosis of RA were followed up. They were divided into two groups according to the basic treatment:  1 44 patients received combination  therapy with RTM and MT; 2 36 patients had MT monotherapy. BMD was assessed by dual-energy X-ray absorptiometry using an Excell XR-46 stationary dual-energy X-ray bone densitometer  (Norland, USA once per year (over 48 months.Results and discussion. The group of patients receiving RTM and MT achieved a statistically significant increase in femoral neck BMD after 36 months of therapy. Statistically significant changes in femoral neck BMD were not revealed in the patients who had MT monotherapy. Lumbar spine BMD was decreased during MT monotherapy, but it remained stable in the RTM + MT group throughout  the 48-month follow-up.Conclusion. Thirty-six-month combination  treatment with RTM and MT provides positive changes in femoral neck BMD, which persists within 48 months after treatment initiation.  Lumbar spine BMD remained stable in the patients receiving RTM and MT.

  14. Clofarabine, idarubicin, and cytarabine (CIA) as frontline therapy for patients ≤60 years with newly diagnosed acute myeloid leukemia.

    Science.gov (United States)

    Nazha, Aziz; Kantarjian, Hagop; Ravandi, Farhad; Huang, Xuelin; Choi, Sangbum; Garcia-Manero, Guillermo; Jabbour, Elias; Borthakur, Gautam; Kadia, Tapan; Konopleva, Marina; Cortes, Jorge; Ferrajoli, Alessandra; Kornblau, Steve; Daver, Naval; Pemmaraju, Naveen; Andreeff, Michael; Estrov, Zeev; Du, Min; Brandt, Mark; Faderl, Stefan

    2013-11-01

    Clofarabine is a second generation nucleoside analogue with activity in adults with acute myeloid leukemia (AML). A phase I trial of clofarabine, idarubicin, and cytarabine (CIA) in relapsed and refractory AML had shown an overall response rate (ORR) of 48%. To explore this combination further, we conducted a phase II study of (CIA) in patients with newly diagnosed AML ≤60 years. Patients ≥18-60 years with AML and adequate organ function were enrolled. Induction therapy consisted of clofarabine (C) 20 mg m⁻² IV daily (days 1-5), idarubicin (I) 10 mg m⁻² IV daily (days 1-3), and cytarabine (A) 1 g m⁻² IV daily (days 1-5). Patients in remission received up to six consolidation cycles (C 15 mg m⁻² × 3, I 8 mg m⁻² × 2, and A 0.75 g m⁻² × 3). Fifty-seven patients were evaluable. ORR was 79%. With a median follow up of 10.9 months, the median overall survival (OS) was not reached, the median event-free survival (EFS) was 13.5 months. Most toxicities were ≤grade 2. Four week mortality was 2%. In subgroup analysis, patients ≤40 years had better OS (P = 0.04) and EFS (P = 0.04) compared to patients >40 years. Compared to historical patients treated with idarubicin and cyarabine (IA), the OS and EFS were significantly longer for CIA treated patients. In multivariate analysis, CIA retained its favorable impact on OS compared to IA. Thus, CIA is an effective and safe therapy for patients ≤60 years with newly diagnosed AML.

  15. Use of Menopausal Hormone Therapy and Bioidentical Hormone Therapy in Australian Women 50 to 69 Years of Age: Results from a National, Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Louiza S Velentzis

    Full Text Available Menopausal Hormone Therapy (MHT use in Australia fell by 55% from 2001 to 2005, following the release of large-scale findings on its risks and benefits. Comprehensive national data, including information on overall prevalence of MHT use as well as information on duration of use in Australia have not been reported since the 2004-5 National Health Survey, when 11% of women aged 45+ years were estimated to be current MHT users. No national data are available on prevalence of use of "bioidentical" hormone therapy (BHT. The objective of this study was to determine recent prevalence of MHT and BHT use. A cross-sectional, national, age-stratified, population survey was conducted in 2013. Eligible women, aged 50-69 years, resident in Australia were randomly sampled in 5-year age groups from the Medicare enrolment database (Australia's universal health scheme. The response rate was 22% based on return of completed questionnaires, and analyses were restricted to 4,389 women within the specified age range. The estimated population-weighted prevalence of current use of MHT was 13% (95%CI 12-14, which was broadly similar to the previously reported national figures in 2004-5, suggesting that the use of MHT in Australia has largely stabilised over the past decade. A total of 39% and 20% of current-users with an intact uterus reported use of oestrogen-progestagen MHT and oestrogen-only MHT, respectively, whereas 77% of hysterectomised current-users used oestrogen-only MHT. Almost three-quarters of current-users [population-weighted prevalence 9% (95%CI 8-10] had used MHT for ≥5 years. In regard to BHT, estimated population-weighted prevalence of ever use was 6% (95%CI 6-7 and 2% (95%CI 2-3 for current use. The population-weighted prevalence of MHT and BHT combined, in current users in their fifties and sixties was 15% (95%CI 14-16. These data provide a recent national "snapshot" of Australian women's use of both conventional MHT and of BHT.

  16. Analysis of 18F-fluorodeoxy-glucose PET imaging data captured before and after Pc 4-mediated photodynamic therapy of U87 tumors in the athymic nude rat

    Science.gov (United States)

    Cross, Nathan; Varghai, Davood; Spring-Robinson, Chandra; Sharma, Rahul; Muzic, Raymond F., Jr.; Oleinick, Nancy L.; Dean, D.

    2007-02-01

    Introduction: Several workers have proposed the use of PET (Positron Emission Tomography) imaging for the outcome assessment of photodynamic therapy (PDT), especially for deep-seated tumors. We report on our study of 18Ffluorodeoxy- glucose (18F-FDG) PET imaging following brain tumor Pc4-PDT. Our working hypothesis was that the tumor's metabolic activity would decline dramatically following Pc 4-PDT owing to tumor necrosis. Methods: Seven days after intraparenchymal implantation of U87 cells, the brains of 12 athymic nude rats were imaged by micro-CT and/or micro-MR. These animals were also 18F-FDG micro-PET (μPET) scanned before and after Pc 4-PDT. 18F-FDG was used to trace metabolic activity that was monitored via μPET. Occurrence of PDT was confirmed on histology. The analysis of 18F-FDG dose and animal weight normalized μPET activity was studied over the 90 minute µPET scan. Results: Currently, μPET data have been studied for: (1) three of the animals that did not indicate tumor necrosis on histology and were assigned to a "Non-PDT" group, and (2) six animals that exhibited tumor necrosis on histology and were assigned to a "PDT" group. The μPET-detected 18F-FDG uptake activity in the tumor region before and after photoirradiation increased in the Non-PDT group an average of 2.28 times, and in the PDT group it increased an average of 1.15 times. Discussion: We are investigating the cause of the increase in 18F-FDG μPET activity that we observed in the PDT group. The methodology used in this study should be useful in determining whether this or other PET, SPECT, or MR functional imaging protocols will detect both the specificity and sensitivity of brain tumor necrosis following Pc 4-PDT.

  17. Neutron-photon mixed field dosimetry by TLD-700 glow curve analysis and its implementation in dose monitoring for Boron Neutron Capture Therapy (BNCT) treatments

    Energy Technology Data Exchange (ETDEWEB)

    Boggio, E. F.; Longhino, J. M. [Centro Atomico Bariloche, Departamento de Fisica de Reactores y Radiaciones / CNEA, Av. E. Bustillo Km 9.5, R8402AGP San Carlos de Bariloche (Argentina); Andres, P. A., E-mail: efboggio@cab.cnea.gov.ar [Centro Atomico Bariloche, Division Proteccion Radiologica / CNEA, Av. E. Bustillo Km 9.5, R8402AGP San Carlos de Bariloche (Argentina)

    2015-10-15

    BNCT is a cancerous cells selective, non-conventional radiotherapy modality to treat malignant tumors such as glioblastoma, melanoma and recurrent head and neck cancer. It consists of a two-step procedure: first, the patient is injected with a tumor localizing drug containing a non-radioactive isotope (Boron-10) with high slow neutron capture cross-section. In a second step, the patient is irradiated with neutrons, which are absorbed by the Boron-10 agent with the subsequently nuclear reaction B- 10(n,a)Li-7, thereby resulting in dose at cellular level due to the high-Let particles. The neutron fields suitable for BNCT are characterized by high neutron fluxes and low gamma dose. Determination of each component is not an easy task, especially when the volume of measurement is quite small or inaccessible for a miniature ionization chamber, for example. A method of measuring the photon and slow neutron dose(mainly by N-14 and B-10) from the glow curve (GC) analysis of a single {sup 7}LiF thermoluminescence detector is evaluated. This method was suggested by the group headed by Dr. Grazia Gambarini. The dosemeters used were TLD-600 ({sup 6}LiF:Mg,Ti with 95.6% {sup 6}Li) and TLD-700 ({sup 7}LiF:Mg,Ti with 99.9% {sup 7}LiF) from Harshaw. Photon dose measurement using the GC analysis method with TLD-700 in mixed fields requires the relation of the two main peaks of a TLD-600 GC shape obtained from an exposition to the same neutron field, and a photon calibrated GC with TLD-700. The requirements for slow neutron dose measurements are similar. In order to properly apply the GC analysis method at the Ra-6 Research Reactor BNCT facility, measurements were carried out in a standard water phantom, fully characterized on the BNCT beam by conventional techniques (activation detectors and paired ionization chambers technique). Next, the method was implemented in whole body dose monitoring of a patient undergoing a BNCT treatment, using a Bo MAb (Bottle Manikin Absorption) phantom

  18. Risk of Recurrent Helicobacter pylori Infection 1 Year After Initial Eradication Therapy in 7 Latin American Communities

    Science.gov (United States)

    Morgan, Douglas R.; Torres, Javier; Sexton, Rachael; Herrero, Rolando; Salazar-Martínez, Eduardo; Robert Greenberg, E.; Bravo, Luis Eduardo; Dominguez, Ricardo L.; Ferreccio, Catterina; Lazcano-Ponce, Eduardo C.; Meza-Montenegro, Maria Mercedes; Peña, Edgar M.; Peña, Rodolfo; Correa, Pelayo; Martínez, María Elena; Chey, William D.; Valdivieso, Manuel; Anderson, Garnet L.; Goodman, Gary E.; Crowley, John J.; Baker, Laurence H.

    2013-01-01

    Importance The long-term effectiveness of Helicobacter pylori eradication programs for preventing gastric cancer will depend on recurrence risk and individual and community factors. Objective To estimate risk of H pylori recurrence and assess factors associated with successful eradication 1 year after treatment. Design, Setting, and Participants Cohort analysis of 1463 randomized trial participants aged 21 to 65 years from 7 Latin American communities, who were treated for H pylori and observed between September 2009 and July 2011. Interventions Randomization to 1 of 3 treatment groups: 14-day lansoprazole, amoxicillin, and clarithromycin (triple therapy); 5-day lansoprazole and amoxicillin followed by 5-day lansoprazole, clarithromycin, and metronidazole (sequential); or 5-day lansoprazole, amoxicillin, clarithromycin, and metronidazole (concomitant). Participants with a positive (13) C-urea breath test (UBT) 6 to 8 weeks posttreatment were offered voluntary re-treatment with 14-day bismuth-based quadruple therapy. Measurements Recurrent infection after a negative posttreatment UBT and factors associated with successful eradication at 1-year follow-up. Results Among participants with UBT-negative results who had a 1-year follow-up UBT (n=1091), 125 tested UBT positive, a recurrence risk of 11.5% (95% CI, 9.6%–13.5%). Recurrence was significantly associated with study site (P=.03), nonadherence to initial therapy (adjusted odds ratio [AOR], 2.94; 95% CI, 1.31–6.13; P=.01), and children in the household (AOR, 1.17; 95% CI, 1.01–1.35 per child; P=.03). Of the 281 with positive posttreatment UBT results, 138 completed re-treatment, of whom 93 tested UBT negative at 1 year. Among the 1340 who had a 1-year UBT, 80.4% (95% CI, 76.4%–83.9%), 79.8% (95% CI, 75.8%–83.5%), and 77.8% (95% CI, 73.6%–81.6%) had UBT-negative results in the triple, sequential, and concomitant groups, respectively (P=.61), with 79.3% overall effectiveness (95% CI, 77.1%–81.5%). In a

  19. Response to three years of growth hormone therapy in girls with Turner syndrome

    Science.gov (United States)

    Park, Hong Kyu; Lee, Hae Sang; Ko, Jung Hee; Hwang, Il Tae

    2013-01-01

    Purpose Short stature is the most common finding in patients with Turner syndrome. Improving the final adult height in these patients is a challenge both for the patients and physicians. We investigated the clinical response of patients to growth hormone treatment for height improvement over the period of three years. Methods Review of medical records from 27 patients with Turner syndrome treated with recombinant human growth hormone for more than 3 years was done. Differences in the changes of height standard deviation scores according to karyotype were measured and factors influencing the height changes were analyzed. Results The response to recombinant human growth hormone was an increase in the height of the subjects to a mean value of 1.1 standard deviation for subjects with Turner syndrome at the end of the 3-year treatment. The height increment in the first year was highest. The height standard deviation score in the third year was negatively correlated with the age at the beginning of the recombinant human growth hormone treatment. Different karyotypes in subjects did not seem to affect the height changes. Conclusion Early growth hormone administration in subjects with Turner syndrome is helpful to improve height response to the treatment. PMID:24904845

  20. Long-Term Effects of AposTherapy in Patients with Osteoarthritis of the Knee: A Two-Year Followup

    Directory of Open Access Journals (Sweden)

    Yaron Bar-Ziv

    2013-01-01

    Full Text Available Several biomechanics treatments for knee osteoarthritis (OA have emerged with the goal of reducing pain and improving function. Through this, researchers have hoped to achieve a transition from the pathological gait patterns to coordinated motor responses. The purpose of the study was to determine the long-term effects of a therapy using a biomechanical device in patients with knee OA. Patients with knee OA were enrolled to active and control groups. The biomechanical device used in therapy (AposTherapy was individually calibrated to each patient in the active group. Patients in the control group received standard treatment. Outcomes were the Western Ontario and McMaster Osteoarthritis Index (WOMAC, Aggregated Locomotor Function (ALF, Short Form 36 (SF-36, and Knee Society Score assessments. The active and control groups were similar at the baseline (group difference in all scores . The active group showed a larger improvement over time between groups in all three WOMAC categories (, 21.7, and 18.1 for pain, stiffness, and function; all , SF-36 Physical Scale (; , Knee Society Knee Score (; , and Knee Society Function Score (; . At the two-year endpoint, the active group showed significantly better results (all . The groups showed a difference of 4.9, 5.6, and 4.7 for the WOMAC pain, stiffness, and function scores, respectively, 10.8 s in ALF score, 30.5 in SF-36 Physical Scale, 16.9 in SF-36 Mental Scale, 17.8 in Knee Society Knee Score, and 25.2 in Knee Society Function Score. The biomechanical therapy examined was shown to significantly reduce pain and improve function and quality of life of patients with knee OA over the long term.

  1. Meningioma 40 years after radiation therapy for retinoblastoma: genetic and phenotypic analysis, and minireview of literature.

    Science.gov (United States)

    Balik, V; Sarissky, M; Lohmann, D; Sulla, I

    2008-11-01

    The authors present a case of 44-year-old Caucasian female diagnosed with meningothelial meningioma 40 years after radiotherapy for sporadic unilateral retinoblastoma. The genetic analysis of DNA from the meningioma revealed no oncogenic mutation in the RB1 gene. The analysis of meningioma cells by flow cytometry revealed the following immunophenotype: vimentin++ CD56+ GFAP- EGFR-. Intermediate intensities of Her-2/neu and Pgp expression were detected in a small percentage of tumour cells. Data suggest that the tumour was most likely induced by radiotherapy and did not arise as a second tumour as there was no hereditary predisposition to retinoblastoma.

  2. Soluble urokinase receptor levels in plasma during 5 years of highly active antiretroviral therapy in HIV-1-infected patients

    DEFF Research Database (Denmark)

    Ostrowski, Sisse R; Katzenstein, Terese L; Piironen, Timo;

    2004-01-01

    High blood levels of the soluble urokinase receptor (suPAR) strongly predict increased mortality in human immunodeficiency virus-1 (HIV-1)-infected patients. This study investigated the plasma concentration of suPAR in 29 treatment-naive HIV-1-infected patients during 5 years treatment with highly...... active antiretroviral therapy (HAART). Plasma suPAR decreased after introducing HAART, most pronounced during the first treatment year. The change in plasma suPAR was independent of changes in viral replication and CD4+ cells but it was strongly correlated with plasma levels of the soluble TNF receptor...... is linked to inflammation in untreated as well as HAART-treated HIV-1-infected patients....

  3. Six Years after a Modified Constraint Induced Movement Therapy (CIMT) Program--What Happens when the Children Have Become Young Adults?

    Science.gov (United States)

    Nordstrand, L.; Eliasson, A. C.

    2013-01-01

    The aim is to describe the development of hand function in young adults with unilateral cerebral palsy (CP), who participated in a 2-week Constraint Induced Movement Therapy (CIMT) camp 6 years earlier. Eleven participants, 16-21 years at follow-up, were assessed at three occasions during 2005 and once in 2011. At the 6-year follow-up, performance…

  4. Body composition in adults with Type 1 diabetes at onset and during the first year of insulin therapy

    DEFF Research Database (Denmark)

    Rosenfalck, A M; Almdal, Thomas Peter; Hilsted, J

    2002-01-01

    . RESULTS: During the first year after onset of diabetes body weight (BW) increased 4.3 +/- 2.9 (0.1-8.3) kg (P = 0.0012) distributed as a 13.3% (1.6 kg) increase in total fat mass (FM) and 4.9% (2.5 kg) increase in lean body soft tissue mass (LBM). The self-reported weight loss at onset was 6.3 +/- 2.5 kg......AIMS: To describe body composition in patients with Type 1 diabetes at diagnosis and during the first year after initiation of insulin therapy. RESEARCH DESIGN AND METHODS: In 10 (eight male and two female) newly onset Type 1 patients, age 31.5 +/- 3.2 years (27-37 years) (sd and range), body mass...... was within the expected range. CONCLUSIONS: During the first year after onset of Type 1 diabetes the mean increase in BW is 6.5% with a 13.3% increase in FM and a 4.9% increase in LBM. Self-reported data on premorbid BW suggest an approximately 10% reduction in BW at onset of Type 1 diabetes. Compared...

  5. Two-Year Follow-Up of Bibliotherapy and Individual Cognitive Therapy for Depressed Older Adults

    Science.gov (United States)

    Floyd, Mark; Rohen, Noelle; Shackelford, Jodie A. M.; Hubbard, Karen L.; Parnell, Marsha B.; Scogin, Forrest; Coates, Adriana

    2006-01-01

    This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre- and posttreatment scores with follow-up scores…

  6. Cardiovascular Safety of One-Year Escitalopram Therapy in Clinically Nondepressed Patients With Acute Coronary Syndrome

    DEFF Research Database (Denmark)

    Hanash, Jamal A; Hansen, Baiba H; Hansen, Jørgen F

    2012-01-01

    : Selective serotonin reuptake inhibitors are commonly used for treatment of depression in patients with cardiac diseases. However, evidence of cardiovascular (CV) safety from randomized trials is based on studies of no longer than 6-month duration. We examined the CV safety of 1-year treatment w...... with Selective serotonin reuptake inhibitor escitalopram compared with placebo in patients with recent acute coronary syndrome (ACS)....

  7. Desmoplasia Influenced Recurrence of Disease and Mortality in Stage III Colorectal Cancer within Five Years after Surgery and Adjuvant Therapy

    Science.gov (United States)

    Zippi, Maddalena; De Toma, Giorgio; Minervini, Giovanni; Cassieri, Claudio; Pica, Roberta; Colarusso, Diodoro; Stock, Simon; Crispino, Pietro

    2017-01-01

    Background/Aims: In patients with colon cancer who undergo resection for potential cure, 40–60% have advanced locoregional disease (stage III). Those who are suitable for adjuvant treatment had a definite disease-free-survival benefit. The aim of the present study was to demonstrate whether the presence of desmoplasia influenced the mortality rate of stage III colorectal cancer (CRC) within 5 years from the surgery and adjuvant therapy. Patients and Methods: Sixty-five patients with stage III CRC underwent resection and adjuvant therapy. Qualitative categorization of desmoplasia was obtained using Ueno's stromal CRC classification. Desmoplasia was related to mortality using Spearman correlation and stratified with other histological variables (inflammation, grading) that concurred to the major determinant of malignancy (venous invasion and lymph nodes) using the Chi-square test. Result: The 5-year survival rate was 65% and the relapse rate was 37%. The mortality rate in patients with immature desmoplasia was 86%, 27% in intermediate desmoplasia, and 0% in mature desmoplasia (Spearman correlation coefficient: −0.572, P = 0.05). Conclusion: Immature desmoplasia appears to be associated with disease recurrence and mortality in stage III CRC patients. PMID:28139499

  8. Desmoplasia influenced recurrence of disease and mortality in stage III colorectal cancer within five years after surgery and adjuvant therapy

    Directory of Open Access Journals (Sweden)

    Maddalena Zippi

    2017-01-01

    Full Text Available Background/Aims: In patients with colon cancer who undergo resection for potential cure, 40–60% have advanced locoregional disease (stage III. Those who are suitable for adjuvant treatment had a definite disease-free-survival benefit. The aim of the present study was to demonstrate whether the presence of desmoplasia influenced the mortality rate of stage III colorectal cancer (CRC within 5 years from the surgery and adjuvant therapy. Patients and Methods: Sixty-five patients with stage III CRC underwent resection and adjuvant therapy. Qualitative categorization of desmoplasia was obtained using Ueno's stromal CRC classification. Desmoplasia was related to mortality using Spearman correlation and stratified with other histological variables (inflammation, grading that concurred to the major determinant of malignancy (venous invasion and lymph nodes using the Chi-square test. Result: The 5-year survival rate was 65% and the relapse rate was 37%. The mortality rate in patients with immature desmoplasia was 86%, 27% in intermediate desmoplasia, and 0% in mature desmoplasia (Spearman correlation coefficient: −0.572,P= 0.05. Conclusion: Immature desmoplasia appears to be associated with disease recurrence and mortality in stage III CRC patients.

  9. Cost-effectiveness analysis of antiretroviral therapy in a cohort of HIV-infected patients starting first-line highly active antiretroviral therapy during 6 years of observation

    Directory of Open Access Journals (Sweden)

    Maggiolo F

    2015-02-01

    Full Text Available Franco Maggiolo,1 Giorgio L Colombo,2,3 Sergio Di Matteo,3 Giacomo M Bruno,3 Noemi Astuti,1 Elisa Di Filippo,1 Giulia Masini,1 Claudia Bernardini1 1Division of Infectious Diseases, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy; 2University of Pavia, Department of Drug Sciences, Pavia, Italy; 3SAVE Studi Analisi Valutazioni Economiche, Milan, Italy Objectives: Costs may play a role in deciding how and when to start highly active antiretroviral therapy (HAART in a naïve patient. The aim of the present study was to assess the cost- effectiveness of treatment with HAART in a large clinical cohort of naïve adults to determine the potential role of single-tablet regimens in the management of patients with human immunodeficiency virus (HIV. An incremental cost-effectiveness ratio analysis was performed, including a quality-adjusted life year approach. Results: In total, 741 patients (females comprising 25.5% were retrospectively included. The mean age was 39 years, the mean CD4 cell count was 266 cells/µL, and the mean viral load was 192,821 copies/mL. The most commonly used backbone was tenofovir + emtricitabine (77.6%; zidovudine + lamivudine was used in 10%, lamivudine + abacavir in 3%, and other nucleoside reverse transcriptase inhibitor (NRTI or NRTI-free regimens in 9.4% of patients. NNRTIs were used in 52.8% of cases, boosted protease inhibitors in 44.1%, and unboosted protease inhibitors and integrase inhibitors in 0.7% and 2.4%, respectively. Starting therapy at CD4 >500 cells/µL and CD4 351–500 cells/µL rather than at <201 cells/µL was the more cost-effective approach. The same consideration was not true comparing current indications with the possibility to start HAART at any CD4 value (eg, >500 cells per µL; in this case, the incremental cost-effectiveness ratio value was €199,130 per quality-adjusted life year gained, a higher value than the one suggested in guidelines. The single-tablet regimen (STR invariably

  10. Preoperative tranilast as adjunctive therapy to primary pterygium surgery with a 1-year follow-up

    Directory of Open Access Journals (Sweden)

    Gildásio C. Almeida Junior

    2015-02-01

    Full Text Available Purpose: To determine the efficacy of tranilast as an adjunctive therapy in conjunctival autograft. Methods: Twenty-nine patients were randomly allocated to the Tranilast Group (n=15 or the Control Group (n=14. The Tranilast Group received a subconjunctival injection of 0.5% tranilast 30 days prior to surgery. Conjunctival autograft was performed in both groups using fibrin sealant and 0.02% subconjunctival mitomycin C at the end of the surgery. After the resection of the pterygium, immunohistochemistry was performed with 100 cells to identify epithelial cells positive for transforming growth factor-β (TGF-β. Subjective symptoms were evaluated using a 5-point scale, and the recurrence rate was assessed. Results: Both groups showed improvements in their symptoms and similar clinical results. Compared with the Control Group, the Tranilast Group failed to show a decreased recurrence rate (p=0.59. However, the number of epithelial cells expressing TGF-β was lower in the Tranilast Group (5 cells; 95% CI: 2.56-13.15; Control Group, 16 cells, 95% CI: 11.53-24.76; p=0.01. Minimal but reversible complications, including glaucoma secondary to corticosteroids and granuloma, occurred during the study. Conclusion: Tranilast was effective in decreasing the number of pterygium epithelial cells expressing TGF-β.

  11. The Capture of Jupiter Trojans

    Science.gov (United States)

    Morbidelli, A.; Nesvorny, D.; Vokrouhlicky, D.

    2013-09-01

    The origin of Jupiter Trojans remained mysterious for decades. Particularly, it was difficult to explain the excitation of the inclinations of the Trojan population [1]. In 2005, Morbidelli et al. [2] proposed a scenario of capture from the trans-Neptunian disk, in the framework of the so-called "Nice model" [3,4]. This scenario explained in a natural way the observed orbital distribution of Trojans. The Nice model, however, evolved in the years, in order to satisfy an increasingly large number of constraints. It now appears that the dynamical evolution of the giant planets was different from that envisioned in [2]. Here, we assess again the process of capture of Trojans within this new evolution. We show that (6-8)×10 - 7 of the original trans-Neptunian planetesimals are captured in the Trojan region, with an orbital distribution consistent with the one observed. Relative to [2], the new capture mechanism has the potential of explaining the asymmetry between the L4 and L5 populations. Moreover, the resulting population of Trojans is consistent with that of the Irregular Satellites of Jupiter, which are captured in the same process; a few bodies from the main asteroid belt could also be captured in the Trojan cloud.

  12. Hypothyroidism is associated with signs of endothelial dysfunction despite 1-year replacement therapy with levothyroxine

    DEFF Research Database (Denmark)

    Clausen, P; Mersebach, H; Nielsen, B

    2009-01-01

    OBJECTIVE: Hypothyroidism is associated with elevated cardiovascular risk, not fully explained by classical risk factors. Instead, endothelial dysfunction may link hypothyroidism to atherosclerosis. The effect of levothyroxine substitution on endothelial function has been sparsely studied...... and the results are unclear. This study tested endothelial function as estimated by concomitant measurements of endothelial dependent vascular dilatory capacity and plasma concentration of von Willebrand factor antigen in patients with hypothyroidism and further examined the impact of subsequent levothyroxine...... substitution. DESIGN AND PATIENTS: Sixteen consecutive patients (13 women, 3 men, aged 46 +/- 11 years) with hypothyroidism were included and compared to 16 matched healthy controls (13 women, 3 men, aged 49 +/- 11 years). Patients with hypothyroidism were reexamined after 3, 6 and 12 months of levothyroxine...

  13. Improved irritative voiding symptoms three years after stereotactic body radiation therapy for prostate cancer.

    Directory of Open Access Journals (Sweden)

    Zakie eRana

    2014-10-01

    Full Text Available Background: Irritative voiding symptoms are common in elderly men and following prostate radiotherapy. The impact of hypofractionated treatment on irritative voiding symptoms has not been determined. This study sought to evaluate urgency, frequency and nocturia following SBRT for prostate cancer. Methods: Patients treated with SBRT monotherapy for localized prostate cancer from August 2007 to July 2011 at Georgetown University Hospital were included in this study. Treatment was delivered using the CyberKnife® with doses of 35 Gy-36.25 Gy in 5 fractions. Patient-reported urinary symptoms were assessed using the International Prostate Symptom Score (IPSS before treatment and at 1, 3, 6, 9, 12 months post-treatment and every 6 months thereafter.Results: 204 patients at a median age of 69 years received SBRT with a median follow-up of 4.8 years. Prior to treatment, 50.0% of patients reported moderate to severe lower urinary track symptoms and 17.7% felt that urinary frequency was a moderate to big problem. The mean prostate volume was 39 cc and 8% had prior procedures for benign prostatic hyperplasia (BPH. A mean baseline IPSS-irritative score of 4.8 significantly increased to 6.5 at 1 month (p 8 at baseline, the mean IPSS-I decreased from a baseline score of 6.8 to 4.9 at three years post-SBRT. This decrease was both statistically (p < 0.0001 and clinically significant (MID = 1.45. Only 14.6% of patients felt that urinary frequency was a moderate to big problem at three years post-SBRT (p = 0.23.Conclusions: Treatment of prostate cancer

  14. Video Screen Capture Basics

    Science.gov (United States)

    Dunbar, Laura

    2014-01-01

    This article is an introduction to video screen capture. Basic information of two software programs, QuickTime for Mac and BlueBerry Flashback Express for PC, are also discussed. Practical applications for video screen capture are given.

  15. Incidence of malaria and efficacy of combination antimalarial therapies over 4 years in an urban cohort of Ugandan children.

    Directory of Open Access Journals (Sweden)

    Tamara D Clark

    Full Text Available BACKGROUND: Combination therapies are now recommended to treat uncomplicated malaria. We used a longitudinal design to assess the incidence of malaria and compare the efficacies of 3 combination regimens in Kampala, Uganda. METHODOLOGY/PRINCIPAL FINDINGS: Children aged 1-10 years were enrolled from randomly selected households in 2004-05 and 2007, and were followed at least monthly through 2008. Insecticide-treated bednets (ITNs were provided in 2006. Children were randomized upon their first episode, and then treated for all episodes of uncomplicated malaria with amodiaquine/sulfadoxine-pyrimethamine (AQ/SP, artesunate/amodiaquine (AS/AQ, or artemether/lumefantrine (AL. Risks of parasitological failure were determined for each episode of uncomplicated malaria and clinical parameters were followed. A total of 690 children experienced 1464 episodes of malaria. 96% of these episodes were uncomplicated malaria and treated with study drugs; 94% were due to Plasmodium falciparum. The rank order of treatment efficacy was AL > AS/AQ > AQ/SP. Failure rates increased over time for AQ/SP, but not the artemisinin-based regimens. Over the 4-year course of the study the prevalence of asymptomatic parasitemia decreased from 11.8% to 1.4%, the incidence of malaria decreased from 1.55 to 0.32 per person year, and the prevalence of anemia (hemoglobin <10 gm/dL decreased from 5.9% to 1.0%. No episodes of severe malaria (based on WHO criteria and no deaths were seen. CONCLUSIONS/SIGNIFICANCE: With ready access to combination therapies and distribution of ITNs, responses were excellent for artemisinin-containing regimens, severe malaria was not seen, and the incidence of malaria and prevalence of parasitemia and anemia decreased steadily over time. TRIAL REGISTRATION: isrctn.org ISRCTN37517549.

  16. Metachronous adenocarcinoma of the remnant oesophagus 15 years following multimodal therapy.

    LENUS (Irish Health Repository)

    Croghan, S

    2015-01-01

    A 53-year-old man underwent neo-adjuvant chemo-radiotherapy and a 2 stage oesophagectomy for a junctional oesophageal tumour in 1996. In March 2012, a metachronous oesophageal tumour was identified, 7cm above the anastomotic margin, on a background of non-inflamed squamous mucosa. He is currently being managed with chemo-radiotherapy. Oesophageal cancer is associated with a historically poor survival rate, with primary concerns being local recurrence or death from disseminated disease. This case highlights the challenges which must be faced, as treatment strategies improve and consequently survival rates increase.

  17. Boron neutron capture therapy of EGFR or EGFRvIII positive gliomas using either boronated monoclonal antibodies or epidermal growth factor as molecular targeting agents

    Energy Technology Data Exchange (ETDEWEB)

    Yang, W. [Department of Pathology, Ohio State University, 165 Hamilton Hall, 1645 Neil Avenue, Columbus, OH 43210 (United States); Barth, R.F. [Department of Pathology, Ohio State University, 165 Hamilton Hall, 1645 Neil Avenue, Columbus, OH 43210 (United States)], E-mail: rolf.barth@osumc.edu; Wu, G. [Department of Pathology, Ohio State University, 165 Hamilton Hall, 1645 Neil Avenue, Columbus, OH 43210 (United States); Tjarks, W. [College of Pharmacy, Ohio State University, Columbus, OH 43210 (United States); Binns, P.; Riley, K. [Nuclear Reactor Laboratory and Department of Nuclear Engineering, Massachusetts Institute of Technology, Cambridge, MA 02215 (United States)

    2009-07-15

    In the present report we have summarized studies carried out over the past five years on molecular targeting of the epidermal growth factor receptor (EGFR) and its mutant isoform, EFGRvIII, for BNCT of genetically engineered F98 rat gliomas, expressing either wildtype (F98{sub EGFR}) or mutant receptors (F98{sub npEGFRvIII}). EGF or the monoclonal antibodies (mAbs), cetuximab (IMC-C225) and L8A4, which recognize wildtype EGFR and EGFRvIII, respectively, were heavily boronated using polyamidoamine (PAMAM) dendrimers (BD) linked to the targeting vehicles by means of heterobifunctional reagents. Boronated EGF or mAbs, alone or in combination with i.v. boronophenylalanine (BPA), were administered intracerebrally (i.c.) by either intratumoral (i.t.) injection or convection enhanced delivery (CED) to rats bearing F98 gliomas following which BNCT was initiated. The best survival data were obtained in rats bearing F98{sub npEGFRvIII} gliomas that had received CED of BD-L8A4 either alone or in combination with i.v. boronophenylalanine (BPA). Studies carried out in rats bearing composite tumors (F98{sub EGFR}/F98{sub npEGFRvIII}) demonstrated that it was essential to target both tumor cell populations in order to obtain an optimal therapeutic effect. Based on these observations, we have concluded that EGFR targeting vehicles are useful, but not stand-alone boron delivery agents due to the heterogeneity of receptor expression in brain tumors. They could, however, be quite useful in combination with the two drugs that currently are being used clinically, BPA and sodium borocaptate (BSH) for BNCT of either brain tumors or head and neck cancers.

  18. DRUG THERAPY OF PAROXYSMAL ATRIAL FIBRILLATION IN THE ELDERLY OVER 75 YEARS OLD

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To investigate the effectiveness and safety of various agents on paroxysmal atrial fibrillation in the elderly over 75 years old.Methods Totally 264 in-patients (75-91 years old, 185 males and 79 females) with atrial fibrillation history of less than 7 days were enrolled in this study. A total of 611 atrial fibrillation episodes were recorded, but 130 episodes (22. 3% ) of atrial fibrillation were auto-converted to sinus rhythm. The rest 481 episodes of atrial fibrillation were divided into six groups based on the drug used. Results The cardioversion ratio of atrial fibrillation were 9. 5%, 46.9%, 71.7%, 55.9%, 32.7%, and73.6%in control, cedilanid, amiodarone, propafenone, verapamil, and quinidine groups, respectively. Ventricular rate control were 5.4%, 83.6%, 84. 9%, 77.9%, 78.8%, and 11.3% in those groups, respectively. The total effective rates of amiodarone and cedilanid groups were the highest. When the ventricular rate was controlled to below 90 bpm, the patients would almost complain of no discomfort. No severe side-effect was observed in each group. Conclusion Amiodarone and cedilanid may be the proper drugs for the treatment of paroxysmal atrial fibrillation in the elderly. The above antiarrhythmics in each therapeutic group were relatively safe and effective.

  19. Capturing the uncultivated majority

    Energy Technology Data Exchange (ETDEWEB)

    Green, Brian D.; Keller, Martin

    2007-04-02

    The metagenomic analysis of environmental microbialcommunities continues to be a rapidly developing area of study. DNAisolation, the first step in capturing the uncultivated majority, hasseen many advances in recent years. Protocols have been developed todistinguish DNA from live versus dead cells and to separate extracellularfrom intracellular DNA. Looking to increase our understanding of the rolethat members of a microbial community play in ecological processes,several techniques have been developed that are enabling greater indepthanalysis of environmental metagenomes. These include the development ofenvironmental gene tags and the serial analysis of 16S rRNA gene sequencetags. In addition, new screening methods have been designed to select forspecific functional genes within metagenomic libraries. Finally, newcultivation methods continue to be developed to improve our ability tocapture a greater diversity of microorganisms within theenvironment.

  20. Use of PET/CT instead of CT-only when planning for radiation therapy does not notably increase life years lost in children being treated for cancer

    DEFF Research Database (Denmark)

    Kornerup, Josefine S.; Brodin, Nils Patrik; Christensen, Charlotte Birk

    2015-01-01

    BACKGROUND: PET/CT may be more helpful than CT alone for radiation therapy planning, but the added risk due to higher doses of ionizing radiation is unknown. OBJECTIVE: To estimate the risk of cancer induction and mortality attributable to the [F-18]2-fluoro-2-deoxyglucose (FDG) PET and CT scans...... used for radiation therapy planning in children with cancer, and compare to the risks attributable to the cancer treatment. MATERIALS AND METHODS: Organ doses and effective doses were estimated for 40 children (2-18 years old) who had been scanned using PET/CT as part of radiation therapy planning....... The risk of inducing secondary cancer was estimated using the models in BEIR VII. The prognosis of an induced cancer was taken into account and the reduction in life expectancy, in terms of life years lost, was estimated for the diagnostics and compared to the life years lost attributable to the therapy...

  1. Hypothesizing the body's genius to trigger and self-organize its healing: 25 years using a standardized neurophysics therapy.

    Science.gov (United States)

    Ross, Sara N; Ware, Ken

    2013-01-01

    We aim for this contribution to operate bi-directionally, both as a "bedside to bench" reverse-translational fractal physiological hypothesis and as a methodological innovation to inform clinical practice. In 25 years using gym equipment therapeutically in non-research settings, the standardized therapy is consistently observed to trigger universal responses of micro to macro waves of system transition dynamics in the human nervous system. These are associated with observably desirable impacts on disorders, injuries, diseases, and athletic performance. Requisite conditions are therapeutic coaching, erect posture, extremely slow movements in mild resistance exercises, and executive control over arousal and attention. To motivate research into the physiological improvements and in validation studies, we integrate from across disciplines to hypothesize explanations for the relationships among the methods, the system dynamics, and evident results. Key hypotheses include: (1) Correctly-directed system efforts may reverse a system's heretofore misdirected efforts, restoring healthier neurophysiology. (2) The enhanced information processing accompanying good posture is an essential initial condition. (3) Behaviors accompanying exercises performed with few degrees of freedom amplify information processing, triggering destabilization and transition dynamics. (4) Executive control over arousal and attention is essential to release system constraints, amplifying and complexifying information. (5) The dynamics create necessary and in many cases evidently sufficient conditions for the body to resolve or improve its own conditions within often short time periods. Literature indicates how the human system possesses material self-awareness. A broad explanation for the nature and effects of the therapy appears rooted in the cascading recursions of the systems' dynamics, which appear to trigger health-fostering self-reorganizing processes when this therapy provides catalytic initial

  2. Use of PET/CT instead of CT-only when planning for radiation therapy does not notably increase life years lost in children being treated for cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kornerup, Josefine S.; Munck af Rosenschoeld, Per [Rigshospitalet, Section of Radiotherapy, Department of Oncology, Copenhagen (Denmark); The Niels Bohr Institute, Faculty of Science, University of Copenhagen, Copenhagen (Denmark); Brodin, Patrik [Rigshospitalet, Section of Radiotherapy, Department of Oncology, Copenhagen (Denmark); Institute for Onco-Physics, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY (United States); Birk Christensen, Charlotte; Borgwardt, Lise [Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); Bjoerk-Eriksson, Thomas [Sahlgrenska University Hospital, Department of Oncology, Gothenburg (Sweden); Kiil-Berthelsen, Anne [Rigshospitalet, Section of Radiotherapy, Department of Oncology, Copenhagen (Denmark); Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark)

    2015-04-01

    PET/CT may be more helpful than CT alone for radiation therapy planning, but the added risk due to higher doses of ionizing radiation is unknown. To estimate the risk of cancer induction and mortality attributable to the [F-18]2-fluoro-2-deoxyglucose (FDG) PET and CT scans used for radiation therapy planning in children with cancer, and compare to the risks attributable to the cancer treatment. Organ doses and effective doses were estimated for 40 children (2-18 years old) who had been scanned using PET/CT as part of radiation therapy planning. The risk of inducing secondary cancer was estimated using the models in BEIR VII. The prognosis of an induced cancer was taken into account and the reduction in life expectancy, in terms of life years lost, was estimated for the diagnostics and compared to the life years lost attributable to the therapy. Multivariate linear regression was performed to find predictors for a high contribution to life years lost from the radiation therapy planning diagnostics. The mean contribution from PET to the effective dose from one PET/CT scan was 24% (range: 7-64%). The average proportion of life years lost attributable to the nuclear medicine dose component from one PET/CT scan was 15% (range: 3-41%). The ratio of life years lost from the radiation therapy planning PET/CT scans and that of the cancer treatment was on average 0.02 (range: 0.01-0.09). Female gender was associated with increased life years lost from the scans (P < 0.001). Using FDG-PET/CT instead of CT only when defining the target volumes for radiation therapy of children with cancer does not notably increase the number of life years lost attributable to diagnostic examinations. (orig.)

  3. Dose distributions in a human head phantom for neutron capture therapy using moderated neutrons from the 2.5 MeV proton-7Li reaction or from fission of 235U

    Science.gov (United States)

    Tanaka, Kenichi; Kobayashi, Tooru; Sakurai, Yoshinori; Nakagawa, Yoshinobu; Endo, Satoru; Hoshi, Masaharu

    2001-10-01

    The feasibility of neutron capture therapy (NCT) using an accelerator-based neutron source of the 7Li(p,n) reaction produced by 2.5 MeV protons was investigated by comparing the neutron beam tailored by both the Hiroshima University radiological research accelerator (HIRRAC) and the heavy water neutron irradiation facility in the Kyoto University reactor (KUR-HWNIF) from the viewpoint of the contamination dose ratios of the fast neutrons and the gamma rays. These contamination ratios to the boron dose were estimated in a water phantom of 20 cm diameter and 20 cm length to simulate a human head, with experiments by the same techniques for NCT in KUR-HWNIF and/or the simulation calculations by the Monte Carlo N-particle transport code system version 4B (MCNP-4B). It was found that the 7Li(p,n) neutrons produced by 2.5 MeV protons combined with 20, 25 or 30 cm thick D2O moderators of 20 cm diameter could make irradiation fields for NCT with depth-dose characteristics similar to those from the epithermal neutron beam at the KUR-HWNIF.

  4. Improvement effect on the depth-dose distribution by CSF drainage and air infusion of a tumour-removed cavity in boron neutron capture therapy for malignant brain tumours

    Science.gov (United States)

    Sakurai, Yoshinori; Ono, Koji; Miyatake, Shin-ichi; Maruhashi, Akira

    2006-03-01

    Boron neutron capture therapy (BNCT) without craniotomy for malignant brain tumours was started using an epi-thermal neutron beam at the Kyoto University Reactor in June 2002. We have tried some techniques to overcome the treatable-depth limit in BNCT. One of the effective techniques is void formation utilizing a tumour-removed cavity. The tumorous part is removed by craniotomy about 1 week before a BNCT treatment in our protocol. Just before the BNCT irradiation, the cerebro-spinal fluid (CSF) in the tumour-removed cavity is drained out, air is infused to the cavity and then the void is made. This void improves the neutron penetration, and the thermal neutron flux at depth increases. The phantom experiments and survey simulations modelling the CSF drainage and air infusion of the tumour-removed cavity were performed for the size and shape of the void. The advantage of the CSF drainage and air infusion is confirmed for the improvement in the depth-dose distribution. From the parametric surveys, it was confirmed that the cavity volume had good correlation with the improvement effect, and the larger effect was expected as the cavity volume was larger.

  5. Persistent inflammation and endothelial activation in HIV-1 infected patients after 12 years of antiretroviral therapy.

    Directory of Open Access Journals (Sweden)

    Frederikke F Rönsholt

    Full Text Available OBJECTIVE: The study investigated markers of inflammation and endothelial activation in HIV infected patients after 12 years of successful combination antiretroviral treatment (cART. METHODS: Inflammation and endothelial activation were assessed by measuring levels of immunoglobulins, β2-microglobulin, interleukin (IL 8, tumor necrosis factor α (TNFα, vascular cell adhesion molecule-1 (sVCAM-1, intercellular adhesion molecule-1 (sICAM-1, sE-Selectin, and sP-Selectin. RESULTS: HIV infected patients had higher levels of β2-microglobulin, IL-8, TNFα, and sICAM-1 than uninfected controls, and HIV infected patients lacked correlation between platelet counts and sP-Selectin levels found in uninfected controls. CONCLUSION: Discrete signs of systemic and vascular inflammation persist even after very long term cART.

  6. Pharmacological Therapy for Myocardial Infarction in the Elderly: An 8-year Analysis

    Directory of Open Access Journals (Sweden)

    Márcia Regina Pinho Makdisse

    2002-04-01

    Full Text Available OBJECTIVE:To assess the changes in the medicamentous treatment of elderly patients hospitalized with acute myocardial infarction occurring over an 8-year period. METHODS:We retrospectively analyzed 379 patients above the age of 65 years with acute myocardial infarction who were admitted to the coronary unit of a university-affiliated hospital from 1990 to 1997. The patients were divided into 2 groups, according to the period of time of hospital admission as follows: group 1 - from 1990 to 1993; and group 2 - from 1994 to 1997. RESULTS:The use of beta-blockers (40.8%chi 75.2%, p<0.0001 and angiotensin-converting enzyme inhibitors (42% chi59.5%, p=0.001 was significantly greater in group 2, while the use of calcium antagonists (42% chi 18.5%, p<0.0001 and general antiarrhythmic drugs (19.1% chi 10.8%, p=0.03 was significantly lower. No significant difference was observed in regard to the use of acetylsalicylic acid, thrombolytic agents, nitrate, and digitalis in the period studied. The length of hospitalization was shorter in group 2 (13.4±8.9 days chi 10.5±7.5 days, p<0.001. The in-hospital mortality was 35.7% in group 1 and 26.6% in group 2 (p=0.07. CONCLUSION: Significant changes were observed in the treatment of elderly patients with acute myocardial infarction, with a greater use of beta-blockers and angiotensin-converting enzyme inhibitors and a lower use of calcium antagonists and antiarrhythmic drugs in group 2. The length of hospitalization and the mortality rate were also lower in group 2, even though the reduction in mortality was not statistically significant.

  7. Self-administered outpatient parenteral antimicrobial therapy: a report of three years experience in the Irish healthcare setting.

    LENUS (Irish Health Repository)

    Kieran, J

    2012-02-01

    Outpatient parenteral antibiotic therapy (OPAT) was first reported in 1972. OPAT programmes are not well established in Ireland, with no reported outcomes in the literature. An OPAT programme was established at St. James Hospital in 2006. Demographics, diagnoses and outcomes of the first 60 courses are reported. A retrospective analysis of prospectively recorded data was performed on patients treated from March 2006 to February 2009. The data was analysed using SPSS v.17. Sixty OPAT courses were administered to 56 patients, 57 percent of which were male. The median age was 50 years, the median inpatient stay was 19 days, the median duration of OPAT was 16 days and 1,289 inpatient bed days were saved. The additional cost per day of OPAT was 167.60 euros. Vancomycin was the most prescribed antimicrobial, administered to 35%. Musculoskeletal infection was the indication for treatment in 50%. Confirmatory microbiological diagnosis was identified in 72%, most frequently due to Staphylococcus aureus (68%). Only minor adverse events were recorded. Clinical cure was achieved in 92.8%. A patient satisfaction survey showed high satisfaction. OPAT is a safe and effective way of providing parenteral antibiotic therapy in the Irish healthcare system. Better integration of funding and the appointment of Infectious Diseases specialists will facilitate its expansion.

  8. Capture Their Attention: Capturing Lessons Using Screen Capture Software

    Science.gov (United States)

    Drumheller, Kristina; Lawler, Gregg

    2011-01-01

    When students miss classes for university activities such as athletic and academic events, they inevitably miss important class material. Students can get notes from their peers or visit professors to find out what they missed, but when students miss new and challenging material these steps are sometimes not enough. Screen capture and recording…

  9. Neurotoxicity and low paclitaxel clearance associated with concomitant clopidogrel therapy in a 60 year old Caucasian woman with ovarian carcinoma

    DEFF Research Database (Denmark)

    Bergmann, Troels K; Filppula, Anne M; Launiainen, Terhi

    2015-01-01

    AIM: The aim of this case report is to describe a novel pharmacokinetic drug-drug interaction between the antiplatelet agent clopidogrel and the antineoplastic agent paclitaxel. METHODS: The patient was identified in a previously described cohort of 93 patients with ovarian carcinoma treated...... with paclitaxel. The effect of clopidogrel acyl-β-D-glucuronide on the metabolism of paclitaxel was assessed in human liver microsomes. The analysis of clopidogrel in plasma and the quantification of paclitaxel and 6α-hydroxypaclitaxel in in vitro samples were performed by liquid chromatography tandem mass...... spectrometry. RESULTS: The patient was a 60 year old female treated with an unknown dose of clopidogrel at the time of paclitaxel therapy. Clopidogrel was present in all the three plasma samples obtained during paclitaxel dosing. Estimated unbound paclitaxel clearance was 238 L/h, which is only 62...

  10. Attachment-Based Family Therapy With a 13-Year-Old Girl Presenting With High Risk for Suicide.

    Science.gov (United States)

    Krauthamer Ewing, E Stephanie; Levy, Suzanne A; Boamah-Wiafe, Linda; Kobak, Roger; Diamond, Guy

    2016-01-01

    This article describes the application of Attachment-Based Family Therapy (ABFT) to the treatment of a 13-year-old female adolescent presenting with high risk of suicide, complicated by a history of depression and sexual trauma. The article begins with an overview of ABFT, including (a) how attachment theory guides treatment; (b) the structure of the clinical model; and (c) the data that provide empirical support. A case example is then presented that exemplifies the primary clinical procedures used to reach therapeutic goals in ABFT, including attachment repair and autonomy/competence promotion. Weekly changes in suicide ideation and depression scores are presented. The article concludes with a discussion about implications for family-based treatment of suicidal youth.

  11. Eliglustat, an investigational oral therapy for Gaucher disease type 1: Phase 2 trial results after 4 years of treatment.

    Science.gov (United States)

    Lukina, Elena; Watman, Nora; Dragosky, Marta; Pastores, Gregory M; Arreguin, Elsa Avila; Rosenbaum, Hanna; Zimran, Ari; Angell, Jennifer; Ross, Leorah; Puga, Ana Cristina; Peterschmitt, Judith M

    2014-12-01

    Eliglustat is an investigational, oral substrate reduction therapy for Gaucher disease type 1 (GD1). Nineteen treatment-naïve patients have now completed 4years of an open-label study (NCT00358150). Mean hemoglobin level and platelet count increased by 2.3±1.5g/dL (baseline: 11.3±1.5g/dL) and 95% (baseline: 68,700±21,200/mm(3)), respectively. Mean spleen and liver volumes (multiples of normal, MN) decreased by 63% (baseline: 17.3±9.5 MN) and 28% (baseline: 1.7±0.4 MN), respectively. Median chitotriosidase and CCL-18 each decreased by 82%; plasma glucosylceramide and GM3 normalized. Mean bone mineral density T-score for the lumbar spine increased by 0.8 (60%) (baseline: -1.6±1.1). Femur dark marrow, a reflection of Gaucher cell infiltration into bone marrow, was reduced or stable in 17/18 patients. There were no bone crises. Most adverse events were mild and unrelated to treatment. These results extend the safety and efficacy of eliglustat reported at 1 and 2 years to 4 years.

  12. An adult patient who developed malignant fibrous histiocytoma 9 years after radiation therapy for childhood acute lymphoblastic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Yasuhiro [National Hiroshima Hospital, Higashi-Hiroshima (Japan); Ohno, Norioki; Horikawa, Yoko; Nishimura, Shin-ichiro; Ueda, Kazuhiro; Shimose, Shoji [Hiroshima Univ. (Japan). School of Medicine

    2002-12-01

    A 24-year-old Japanese man with a history of acute lymphoblastic leukemia, which occurred during childhood, developed malignant fibrous histiocytoma of his left knee. His past history revealed that he had undergone leukemic blast cell invasion of the left knee and subsequent radiation therapy 9 years ago. The total radiation doses for the upper part of the left tibia and the lower part of the left femur were 60 Gy and 40 Gy, respectively. Neither distant metastasis nor a relapse of leukemia occurred. A curative resection of the left femur with a noninvasive margin was performed. Adjuvant chemotherapy including high-dose methotrexate was given successfully before and after surgery; this was followed by relapse-free survival for 3 years. The nature of postirradiation malignant fibrous histiocytoma is highly aggressive. When a patient complains of persistent symptoms in a previously irradiated field, the possibility of this tumor must be taken into account. The importance of early diagnosis cannot be over-emphasized. (author)

  13. Transcatheter arterial embolization as therapy of renal angiomyolipomas: The evolution in 15 years of experience

    Energy Technology Data Exchange (ETDEWEB)

    Chatziioannou, A.; Gargas, D. [University of Athens, Aretaieion Hospital, Radiology Department (Greece); Malagari, K. [University of Athens, Imaging and Research Unit, Evgenidion Hospital (Greece); Kornezos, I., E-mail: kornezos@gmail.com [University of Athens, Aretaieion Hospital, Radiology Department (Greece); Ioannidis, I.; Primetis, E. [University of Athens, Aretaieion Hospital, Radiology Department (Greece); Moschouris, H. [University of Athens, Imaging and Research Unit, Evgenidion Hospital (Greece); Gouliamos, A.; Mourikis, D. [University of Athens, Aretaieion Hospital, Radiology Department (Greece)

    2012-09-15

    Objective: This study aims at presenting the evolution of the embolization technique in treating renal angiomyolipomas (AMLs) either diagnosed in patients with acute bleeding or discovered accidentally. Methods: Ten patients with renal AMLs have been through thirteen selective transcatheter arterial embolizations for 15 years. Two patients had tuberous sclerosis complex (TSC) with bilateral tumors and were embolized twice. Four embolic materials were employed: PVA particles, Gianturco coils, microspheres and microcoils. Catheterization was achieved by means of 5F Cobra 2 catheters and coaxial microcatheter systems. Results: On an emergency basis, embolization was a first-line treatment. In one case, surgery was necessary; in two patients, a second embolization was performed. When treatment was preventive, a single embolization proved to be sufficient, as well. There was no significant deterioration of the serum creatinine levels in the post-embolization period. Conclusion: Selective arterial embolization is a rather safe and effective technique to treat AMLs both urgently and preventively. Different embolic materials can be employed. Microspheres and microcatheters stand for new promising materials.

  14. One Year Follow-Up to Modular Cognitive Behavioral Therapy for the Treatment of Pediatric Anxiety Disorders in an Elementary School Setting

    Science.gov (United States)

    Galla, Brian M.; Wood, Jeffrey J.; Chiu, Angela W.; Langer, David A.; Jacobs, Jeffrey; Ifekwunigwe, Muriel; Larkins, Clare

    2012-01-01

    The current study sought to evaluate the relative long-term efficacy of a modularized cognitive behavioral therapy (CBT) program for children with anxiety disorders. Twenty four children (5-12 years old) randomly assigned to modular CBT or a 3-month waitlist participated in a 1-year follow-up assessment. Independent evaluators blind to treatment…

  15. Neutron capture therapy beam design at Harwell.

    Science.gov (United States)

    Constantine, G

    1990-01-01

    At Harwell, we have progressed from designing, building, and using small-diameter beams of epithermal neutrons for radiobiology studies to designing a radiotherapy facility for the 25-MW research reactor DIDO. The program is well into the survey phase, where the main emphasis is on tailoring the neutron spectrum. The incorporation of titanium and vanadium in an aluminium spectrum shaper in the D2O reflector has been shown to yield a significant reduction in the mean energy of neutrons incident on the patient by suppression of streaming through the cross-section window in aluminium at 25 keV.

  16. Dosimetry methods in boron neutron capture therapy

    Energy Technology Data Exchange (ETDEWEB)

    Gambarini, G.; Artuso, E.; Felisi, M.; Regazzoni, V.; Giove, D. [Universita degli Studi di Milano, Department of Physics, Via Festa del Patrono 7, 20122 Milano (Italy); Agosteo, S.; Barcaglioni, L. [Istituto Nazionale di Fisica Nucleare, Milano (Italy); Campi, F.; Garlati, L. [Politecnico di Milano, Energy Department, Piazza Leonardo Da Vinci 32, 20133 Milano (Italy); De Errico, F. [Universita degli Studi di Pisa, Department of Civil and Industrial Engineering, Lungamo Pacinotti 43, 56126 Pisa (Italy); Borroni, M.; Carrara, M. [Fondazione IRCCS Istituto Nazionale Tumori, Medical Physics Unit, Via Venezian 1, 20133 Milano (Italy); Burian, J.; Klupak, V.; Viererbl, L.; Marek, M. [Research Centre Rez, Department of Neutron Physics, 250-68 Husinec-Rez (Czech Republic)

    2014-08-15

    Dosimetry studies have been carried out at thermal and epithermal columns of Lvr-15 research reactor for investigating the spatial distribution of gamma dose, fast neutron dose and thermal neutron fluence. Two different dosimetry methods, both based on solid state detectors, have been studied and applied and the accuracy and consistency of the results have been inspected. One method is based on Fricke gel dosimeters that are dilute water solutions and have good tissue equivalence for neutrons and also for all the secondary radiations produced by neutron interactions in tissue or water phantoms. Fricke gel dosimeters give the possibility of separating the various dose contributions, i.e. the gamma dose, the fast neutron dose and the dose due to charged particles generated during thermal neutron reactions by isotopes having high cross section, like 10-B. From this last dose, thermal neutron fluence can be obtained by means of the kerma factor. The second method is based on thermoluminescence dosimeters. In particular, the developed method draw advantage from the different heights of the peaks of the glow curve of such phosphors when irradiated with photons or with thermal neutrons. The results show that satisfactory results can be obtained with simple methods, in spite of the complexity of the subject. However, the more suitable dosimeters and principally their utilization and analysis modalities are different for the various neutron beams, mainly depending on the relative intensities of the three components of the neutron field, in particular are different for thermal and epithermal columns. (Author)

  17. Quantitative evaluation of boron neutron capture therapy (BNCT) drugs for boron delivery and retention at subcellular-scale resolution in human glioblastoma cells with imaging secondary ion mass spectrometry (SIMS).

    Science.gov (United States)

    Chandra, S; Ahmad, T; Barth, R F; Kabalka, G W

    2014-06-01

    Boron neutron capture therapy (BNCT) of cancer depends on the selective delivery of a sufficient number of boron-10 ((10)B) atoms to individual tumour cells. Cell killing results from the (10)B (n, α)(7) Li neutron capture and fission reactions that occur if a sufficient number of (10)B atoms are localized in the tumour cells. Intranuclear (10)B localization enhances the efficiency of cell killing via damage to the DNA. The net cellular content of (10)B atoms reflects both bound and free pools of boron in individual tumour cells. The assessment of these pools, delivered by a boron delivery agent, currently cannot be made at subcellular-scale resolution by clinically applicable techniques such as positron emission tomography and magnetic resonance imaging. In this study, a secondary ion mass spectrometry based imaging instrument, a CAMECA IMS 3f ion microscope, capable of 500 nm spatial resolution was employed. Cryogenically prepared cultured human T98G glioblastoma cells were evaluated for boron uptake and retention of two delivery agents. The first, L-p-boronophenylalanine (BPA), has been used clinically for BNCT of high-grade gliomas, recurrent tumours of the head and neck region and melanomas. The second, a boron analogue of an unnatural amino acid, 1-amino-3-borono-cyclopentanecarboxylic acid (cis-ABCPC), has been studied in rodent glioma and melanoma models by quantification of boron in the nucleus and cytoplasm of individual tumour cells. The bound and free pools of boron were assessed by exposure of cells to boron-free nutrient medium. Both BPA and cis-ABCPC delivered almost 70% of the pool of boron in the free or loosely bound form to the nucleus and cytoplasm of human glioblastoma cells. This free pool of boron could be easily mobilized out of the cell and was in some sort of equilibrium with extracellular boron. In the case of BPA, the intracellular free pool of boron also was affected by the presence of phenylalanine in the nutrient medium. This

  18. Two-Year Follow-Up Analysis of Telaprevir-Based Antiviral Triple Therapy for HCV Recurrence in Genotype 1 Infected Liver Graft Recipients as a First Step towards Modern HCV Therapy

    Science.gov (United States)

    Neuhaus, Ruth; Eurich, Dennis; Hofmann, Jörg; Bayraktar, Sandra; Pratschke, Johann; Bahra, Marcus

    2016-01-01

    Objective. The introduction of protease inhibitors telaprevir and boceprevir in 2011 had extended the antiviral treatment options especially in genotype 1 infected hepatitis C relapsers and nonresponders to interferon/ribavirin therapy. The aim of this study was to analyze the long-term treatment efficiency of telaprevir-based triple therapy for patients with hepatitis C reinfection after orthotopic liver transplantation. Patients and Methods. We included 12 patients with histologically confirmed graft fibrosis due to hepatitis C reinfection. The treatment duration was scheduled as 12 weeks of telaprevir-based antiviral triple therapy followed by 36 weeks of dual therapy with pegylated interferon/ribavirin. The patients were followed up for two years after the end of triple therapy. Results. Of the 12 patients, 6 (50%) completed the full 48 weeks of antiviral treatment. An end of treatment response and a sustained virological response 52 weeks after the end of the antiviral treatment course were achieved in 8/12 (67%) and 7/12 (58%) patients, respectively. Conclusion. Telaprevir-based triple therapy was shown to be a long-term effective but complex treatment option for individual patients with hepatitis C graft. With the recent improvements in hepatitis C therapy options telaprevir may not be recommended as a standard therapy for this indication anymore. PMID:27195149

  19. 18 years long-term results of facial port-wine stain (PWS) after photodynamic therapy (PDT)--a case report.

    Science.gov (United States)

    Yu, Wenxin; Ma, Gang; Qiu, Yajing; Chen, Hui; Jin, Yunbo; Yang, Xi; Hu, Xiaojie; Chang, Lei; Wang, Tianyou; Zhou, Henghua; Li, Wei; Lin, Xiaoxi

    2015-03-01

    Port-wine stain (PWS) is still a challenging condition for clinician to treat, because in the majority of cases, the stains are not lifted fully by treatment with laser therapy. Photodynamic therapy (PDT) was considered recently as a promising alternative treatment for PWS. We report here long-term follow-up measures 18 years on PWS lesion treated with PDT and the histological data of residual PWS.

  20. Neutron Capture Nucleosynthesis

    CERN Document Server

    Kiss, Miklos

    2016-01-01

    Heavy elements (beyond iron) are formed in neutron capture nucleosynthesis processes. We have proposed a simple unified model to investigate the neutron capture nucleosynthesis in arbitrary neutron density environment. We have also investigated what neutron density is required to reproduce the measured abundance of nuclei assuming equilibrium processes. We found both of these that the medium neutron density has a particularly important role at neutron capture nucleosynthesis. About these results most of the nuclei can formed at medium neutron capture density environment e.g. in some kind of AGB stars. Besides these observations our model is capable to use educational purpose.

  1. High-power electron beam tests of a liquid-lithium target and characterization study of (7)Li(p,n) near-threshold neutrons for accelerator-based boron neutron capture therapy.

    Science.gov (United States)

    Halfon, S; Paul, M; Arenshtam, A; Berkovits, D; Cohen, D; Eliyahu, I; Kijel, D; Mardor, I; Silverman, I

    2014-06-01

    A compact Liquid-Lithium Target (LiLiT) was built and tested with a high-power electron gun at Soreq Nuclear Research Center (SNRC). The target is intended to demonstrate liquid-lithium target capabilities to constitute an accelerator-based intense neutron source for Boron Neutron Capture Therapy (BNCT) in hospitals. The lithium target will produce neutrons through the (7)Li(p,n)(7)Be reaction and it will overcome the major problem of removing the thermal power >5kW generated by high-intensity proton beams, necessary for sufficient therapeutic neutron flux. In preliminary experiments liquid lithium was flown through the target loop and generated a stable jet on the concave supporting wall. Electron beam irradiation demonstrated that the liquid-lithium target can dissipate electron power densities of more than 4kW/cm(2) and volumetric power density around 2MW/cm(3) at a lithium flow of ~4m/s, while maintaining stable temperature and vacuum conditions. These power densities correspond to a narrow (σ=~2mm) 1.91MeV, 3mA proton beam. A high-intensity proton beam irradiation (1.91-2.5MeV, 2mA) is being commissioned at the SARAF (Soreq Applied Research Accelerator Facility) superconducting linear accelerator. In order to determine the conditions of LiLiT proton irradiation for BNCT and to tailor the neutron energy spectrum, a characterization of near threshold (~1.91MeV) (7)Li(p,n) neutrons is in progress based on Monte-Carlo (MCNP and Geant4) simulation and on low-intensity experiments with solid LiF targets. In-phantom dosimetry measurements are performed using special designed dosimeters based on CR-39 track detectors.

  2. Computational assessment of deep-seated tumor treatment capability of the 9Be(d,n)10B reaction for accelerator-based boron neutron capture therapy (AB-BNCT).

    Science.gov (United States)

    Capoulat, M E; Minsky, D M; Kreiner, A J

    2014-03-01

    The 9Be(d,n)10B reaction was studied as an epithermal neutron source for brain tumor treatment through Boron Neutron Capture Therapy (BNCT). In BNCT, neutrons are classified according to their energies as thermal (epithermal (from 0.5 eV to 10 keV) or fast (>10 keV). For deep-seated tumors epithermal neutrons are needed. Since a fraction of the neutrons produced by this reaction are quite fast (up to 5-6 MeV, even for low-bombarding energies), an efficient beam shaping design is required. This task was carried out (1) by selecting the combinations of bombarding energy and target thickness that minimize the highest-energy neutron production; and (2) by the appropriate choice of the Beam Shaping Assembly (BSA) geometry, for each of the combinations found in (1). The BSA geometry was determined as the configuration that maximized the dose deliverable to the tumor in a 1 h treatment, within the constraints imposed by the healthy tissue dose adopted tolerance. Doses were calculated through the MCNP code. The highest dose deliverable to the tumor was found for an 8 μm target and a deuteron beam of 1.45 MeV. Tumor weighted doses ≥40 Gy can be delivered up to about 5 cm in depth, with a maximum value of 51 Gy at a depth of about 2 cm. This dose performance can be improved by relaxing the treatment time constraint and splitting the treatment into two 1-h sessions. These good treatment capabilities strengthen the prospects for a potential use of this reaction in BNCT.

  3. Boron neutron capture therapy (BNCT) for liver metastasis in an experimental model: dose–response at five-week follow-up based on retrospective dose assessment in individual rats

    Energy Technology Data Exchange (ETDEWEB)

    Emiliano C. C. Pozzi; Veronica A. Trivilin; Lucas L. Colombo; Andrea Monti Hughes; Silvia I. Thorp; Jorge E. Cardoso; Marcel A. Garabalino; Ana J. Molinari; Elisa M. Heber; Paula Curotto; Marcelo Miller; Maria E. Itoiz; Romina F. Aromando; David W. Nigg; Amanda E. Schwint

    2013-11-01

    Boron neutron capture therapy (BNCT) was proposed for untreatable colorectal liver metastases. Employing an experimental model of liver metastases in rats, we recently demonstrated that BNCT mediated by boronophenylalanine (BPA-BNCT) at 13 Gy prescribed to tumor is therapeutically useful at 3-week follow-up. The aim of the present study was to evaluate dose–response at 5-week follow-up, based on retrospective dose assessment in individual rats. BDIX rats were inoculated with syngeneic colon cancer cells DHD/K12/TRb. Tumor-bearing animals were divided into three groups: BPA-BNCT (n = 19), Beam only (n = 8) and Sham (n = 7) (matched manipulation, no treatment). For each rat, neutron flux was measured in situ and boron content was measured in a pre-irradiation blood sample for retrospective individual dose assessment. For statistical analysis (ANOVA), individual data for the BPA-BNCT group were pooled according to absorbed tumor dose, BPA-BNCT I: 4.5–8.9 Gy and BPA-BNCT II: 9.2–16 Gy. At 5 weeks post-irradiation, the tumor surface area post-treatment/pre-treatment ratio was 12.2 +/- 6.6 for Sham, 7.8 +/- 4.1 for Beam only, 4.4 +/- 5.6 for BPA-BNCT I and 0.45 +/- 0.20 for BPA-BNCT II; tumor nodule weight was 750 +/- 480 mg for Sham, 960 +/- 620 mg for Beam only, 380 +/- 720 mg for BPA-BNCT I and 7.3 +/- 5.9 mg for BPA-BNCT II. The BPA-BNCT II group exhibited statistically significant tumor control with no contributory liver toxicity. Potential threshold doses for tumor response and significant tumor control were established at 6.1 and 9.2 Gy, respectively.

  4. Blood-brain barrier (BBB) toxicity and permeability assessment after L-(4-¹⁰Boronophenyl)alanine, a conventional B-containing drug for boron neutron capture therapy, using an in vitro BBB model.

    Science.gov (United States)

    Roda, E; Nion, S; Bernocchi, G; Coccini, T

    2014-10-01

    Since brain tumours are the primary candidates for treatment by Boron Neutron Capture Therapy, one major challenge in the selective drug delivery to CNS is the crossing of the blood-brain barrier (BBB). The present pilot study investigated (i) the transport of a conventional B-containing product (i.e., L-(4-(10)Boronophenyl)alanine, L-(10)BPA), already used in medicine but still not fully characterized regarding its CNS interactions, as well as (ii) the effects of the L-(10)BPA on the BBB integrity using an in vitro model, consisting of brain capillary endothelial cells co-cultured with glial cells, closely mimicking the in vivo conditions. The multi-step experimental strategy (i.e. Integrity test, Filter study, Transport assay) checked L-(10)BPA toxicity at 80 µg Boron equivalent/ml, and its ability to cross the BBB, additionally by characterizing the cytoskeletal and TJ's proteins by immunocytochemistry and immunoblotting. In conclusion, a lack of toxic effects of L-(10)BPA was demonstrated, nevertheless accompanied by cellular stress phenomena (e.g. vimentin expression modification), paralleled by a low permeability coefficient (0.39 ± 0.01 × 10(-3)cm min(-1)), corroborating the scarce probability that L-(10)BPA would reach therapeutically effective cerebral concentration. These findings emphasized the need for novel strategies aimed at optimizing boron delivery to brain tumours, trying to ameliorate the compound uptake or developing new targeted products suitable to safely and effectively treat head cancer. Thus, the use of in vitro BBB model for screening studies may provide a useful early safety assessment for new effective compounds.

  5. Study of enzyme replacement therapy for Gaucher Disease: comparative analysis of clinical and laboratory parameters at diagnosis and after two, five and ten years of treatment

    Directory of Open Access Journals (Sweden)

    Ana Maria Almeida Souza

    2014-10-01

    Full Text Available Objective: To evaluate the impact of enzyme replacement therapy for Gaucher Disease on clinical and laboratory parameters after two, five and ten years of treatment. Methods: Data were collected from patient records and analyzed using BioEstat software (version 5.0. Student's t-test, Analysis of Variance (ANOVA, Wilcoxon test and Kruskal–Wallis test were used for statistical analysis. Hepatomegaly and splenomegaly were analyzed using the Kappa test. Results: There was a significant increase in hemoglobin levels (p-value <0.01 and platelet counts (p-value = 0.01 within two years of therapy. At the same time, the frequencies of splenomegaly (p-value <0.01 and hepatomegaly (p-value <0.05 reduced. These results were similar at five and ten years of enzyme replacement therapy. Conclusions: There are substantial and quick (within two years laboratory and clinical responses to enzyme replacement therapy. These improvements continue as long as enzyme replacement therapy is administered every two weeks, as recommended by the literature.

  6. Mucopolysaccharidosis type VI on enzyme replacement therapy since infancy: Six years follow-up of four children

    Directory of Open Access Journals (Sweden)

    Dafne D.G. Horovitz

    2015-12-01

    Full Text Available Clinical and biochemical improvements are reported on Mucopolysaccharidosis type VI (MPS VI patients on Enzyme Replacement Therapy (ERT with rhASB (galsulfase, Naglazyme®, and preclinical and clinical studies have shown clinical benefits of early initiation. We report four unrelated MPS VI children who began ERT as infants (ages 5 days–10 months. The three older patients showed the first clinical signs of MPS VI at baseline, also presenting different degrees of dysostosis multiplex, and two had mild heart disease. The two oldest also had mild facial coarseness, one had hearing conduction deficit and sleep disorder and the other corneal clouding at baseline. After six years on ERT, all four patients have normal urinary GAG values. Although they all showed normal motor and mental development, brain and cervical spine MRI images available from two of the older patients showed abnormalities, while the youngest child continues having normal images. The four patients presented slower progression of bone and joint disease when compared to their affected older siblings. It should be noticed that only two patients in this sample are currently below the 3rd percentile for height: the youngest who has a constitutional factor associated and the eldest who already presented frank dysostosis at 10 months of age. These findings confirm previous studies that report that skeletal features of the disease cannot be completely prevented despite early ERT. Heart disease already present in two of the four infants at baseline got worse over time and appeared in another patient, but the youngest child on ERT introduction still has a normal echocardiogram at six years of age; he also is the only one without corneal clouding after six years follow-up. Our results also suggest that early ERT prevented storage in spleen and liver and may also have improved or prevented progression of facial dysmorphic features, corroborating similar findings seen in previous studies

  7. Focal therapy with high-intensity focused ultrasound for prostate cancer in the elderly: a feasibility study with 10 years follow-up

    Directory of Open Access Journals (Sweden)

    Amine B. El Fegoun

    2011-04-01

    Full Text Available PURPOSE: To evaluate the long-term efficacy of prostate cancer control and complication rates, in the elderly, after focal therapy with high-intensity focused ultrasound (HIFU. MATERIALS AND METHODS: Between June 1997 and March 2000, patients with localized prostate cancer were included into a focal therapy protocol. Inclusion criteria were: PSA < 10 ng/mL, < 3 positive biopsies with only 1 lobe involved, clinical stage < T2a, Gleason score < 7 (3+4, negative CT scan and bone scan. Hemi-ablation of the prostate was performed with the Ablatherm(R device. Survival, complication rates and urinary continence were evaluated. Control biopsies were performed at 1 year. Treatment failure was defined as a positive biopsy or need for salvage therapy. RESULTS: Twelve patients with a mean age 70 years were included. Median follow-up was 10 years. Control prostate biopsies were negative in 11/12 (91% patients. Overall survival was 83% (10/12 and cancer specific survival was 100% at 10 years. Two patients died from other causes. Recurrence free survival was 90% (95% CI; 0.71-1 at 5 years, and 38% (95% CI; 0.04-0.73 at 10 years. Five patients had salvage therapy with repeat HIFU (n = 1 or hormonal therapy (n = 4 and all salvage patients were alive at 10 years. No patients developed lymph node or bone metastasis. No patients suffered from urinary incontinence. International Prostate Symptom Score was stable at 1 year. Complications included two urinary tract infections and one episode of acute urinary retention. CONCLUSIONS: Hemi-prostate ablation with HIFU can be safely performed in selected elderly patients with adequate long-term cancer control and low complication rates. Results from larger prospective studies using improved imaging techniques and extensive biopsy protocols are awaited.

  8. Carbon Capture and Storage

    NARCIS (Netherlands)

    Benson, S.M.; Bennaceur, K.; Cook, P.; Davison, J.; Coninck, H. de; Farhat, K.; Ramirez, C.A.; Simbeck, D.; Surles, T.; Verma, P.; Wright, I.

    2012-01-01

    Emissions of carbon dioxide, the most important long-lived anthropogenic greenhouse gas, can be reduced by Carbon Capture and Storage (CCS). CCS involves the integration of four elements: CO 2 capture, compression of the CO2 from a gas to a liquid or a denser gas, transportation of pressurized CO 2

  9. The risk of burn injury during long-term oxygen therapy: a 17-year longitudinal national study in Sweden

    Directory of Open Access Journals (Sweden)

    Tanash HA

    2015-11-01

    Full Text Available Hanan A Tanash,1 Fredrik Huss,2,3 Magnus Ekström41Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, 2Department of Surgical Sciences, Plastic Surgery, Uppsala University, 3Burn Center, Department of Plastic and Maxillofacial Surgery, University Hospital of Uppsala, Uppsala, 4Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, SwedenBackground: Long-term oxygen therapy (LTOT improves the survival time in hypoxemic chronic obstructive pulmonary disease. Despite warnings about potential dangers, a considerable number of patients continue to smoke while on LTOT. The incidence of burn injuries related to LTOT is unknown. The aim of this study was to estimate the rate of burn injury requiring health care contact during LTOT.Methods: Prospective, population-based, consecutive cohort study of people starting LTOT from any cause between January 1, 1992 and December 31, 2009 in the Swedish National Register of Respiratory Failure (Swedevox.Results: In total, 12,497 patients (53% women were included. The mean (standard deviation age was 72±9 years. The main reasons for starting LTOT were chronic obstructive pulmonary disease (75% and pulmonary fibrosis (15%. Only 269 (2% were active smokers when LTOT was initiated. The median follow-up time to event was 1.5 years (interquartile range, 0.55–3.1. In total, 17 patients had a diagnosed burn injury during 27,890 person-years of LTOT. The rate of burn injury was 61 (95% confidence interval, 36–98 per 100,000 person-years. There was no statistically significant difference in the rate of burn injury between ever-smokers and never-smokers, or between men and women.Conclusion: The rate of burn injuries in patients on LTOT seems to be low in Sweden. The strict requirements in Sweden for smoking cessation before LTOT initiation may contribute to this finding.Keywords: respiratory failure, oxygen, fire

  10. Acute Renal Replacement Therapy in Children with Diarrhea-Associated Hemolytic Uremic Syndrome: A Single Center 16 Years of Experience

    Directory of Open Access Journals (Sweden)

    Silviu Grisaru

    2011-01-01

    Full Text Available Acute kidney injury (AKI is becoming more prevalent among hospitalized children, its etiologies are shifting, and new treatment modalities are evolving; however, diarrhea-associated hemolytic uremic syndrome (D+HUS remains the most common primary disease causing AKI in young children. Little has been published about acute renal replacement therapy (ARRT and its challenges in this population. We describe our single center's experience managing 134 pediatric patients with D+HUS out of whom 58 (43% required ARRT over the past 16 years. In our cohort, all but one patient were started on peritoneal dialysis (PD. Most patients, 47 (81%, received acute PD on a pediatric inpatient ward. The most common recorded complications in our cohort were peritoneal fluid leaks 13 (22%, peritonitis 11 (20%, and catheter malfunction 5 (9%. Nine patients (16% needed surgical revision of their PD catheters. There were no bleeding events related to PD despite a mean platelets count of 40.9 (±23.5 × 103/mm3 and rare use of platelets infusions. Despite its methodological limitations, this paper adds to the limited body of evidence supporting the use of acute PD as the primary ARRT modality in children with D+HUS.

  11. Long-term persistence with injectable therapy in relapsing-remitting multiple sclerosis: an 18-year observational cohort study.

    Directory of Open Access Journals (Sweden)

    Simon Zhornitsky

    Full Text Available Disease modifying therapies (DMTs reduce the frequency of relapses and accumulation of disability in multiple sclerosis (MS. Long-term persistence with treatment is important to optimize treatment benefit. This long-term, cohort study was conducted at the Calgary MS Clinic. All consenting adults with relapsing-remitting MS who started either glatiramer acetate (GA or interferon-β 1a/1b (IFN-β between January 1st, 1996 and July 1st, 2011 were included. Follow-up continued to February 1st, 2014. Time-to-discontinuation of the initial and subsequently-prescribed DMTs (switches was analysed using Kaplan-Meier survival analyses. Group differences were compared using log-rank tests and multivariable Cox regression models. Analysis included 1471 participants; 906 were initially prescribed GA and 565 were initially prescribed IFN-β. Follow-up information was available for 87%; 29 (2% were lost to follow-up and 160 (11% moved from Southern Alberta while still using DMT. Median time-to-discontinuation of all injectable DMTs was 11.1 years. Participants with greater disability at treatment initiation, those who started treatment before age 30, and those who started between 2006 and 2011 were more likely to discontinue use of all injectable DMTs. Median time-to-discontinuation of the initial DMT was 8.6 years. Those initially prescribed GA remained on treatment longer. Of 610 participants who discontinued injectable DMT, 331 (54% started an oral DMT, or a second-line DMT, or resumed injectable DMT after 90 days. Persistence with injectable DMTs was high in this long-term population-based study. Most participants who discontinued injectable DMT did not remain untreated. Further research is required to understand treatment outcomes and outcomes after stopping DMT.

  12. One-year follow-up results of a randomized controlled clinical trial on internet-based cognitive behavioral therapy for subthreshold depres- sion in people over 50 years old.

    NARCIS (Netherlands)

    Spek, V.; Cuijpers, P.; Nyklicek, I.; Smits, N.; Riper, H.; Pop, V.

    2008-01-01

    Background Internet-based cognitive behaviour therapy (CBT) is a promising new approach for the treatment of depressive symptoms. The current study had two aims: (1) to determine whether, after 1 year, an internet-based CBT intervention was more effective than a waiting-list control group; and (2) t

  13. Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience

    Directory of Open Access Journals (Sweden)

    Anichini R

    2013-04-01

    Full Text Available Roberto Anichini,1 Sabrina Cosimi,2 Alberto Di Carlo,3 Paola Orsini,4 Alessandra De Bellis,1 Giuseppe Seghieri,1 Flavia Franconi,5 Fabio Baccetti6 1Diabetes Unit, Spedali Riuniti, Pistoia, Italy; 2Diabetes Unit, Hospital of Versilia, Camaiore (LU, Italy; 3Diabetes Unit, Hospital of Lucca, Italy; 4Diabetes Unit, Hospital of Livorno, Italy; 5Department of Biochemical Sciences, University of Sassari, Italy; 6Diabetes Unit, Hospital of Massa, Italy Purpose: To investigate whether gender affects therapeutic response by exenatide twice a day (BID in type 2 diabetes by using a database concerning patients monitored by five outpatient clinics in Tuscany, Italy. Patients and methods: We considered a cohort of 315 (154 male/161 female patients experiencing therapeutic failure while on oral therapy (metformin, or combination therapy metformin + sulphonylureas, who were given exenatide (10 µg/BID and who fully completed 4 months, 8 months, and 12 months of follow-ups. Results: Among patients stratified by gender and well matched for age, body mass index, and hemoglobin A1c (HbA1c, it was found that the length of disease was longer in females than in males (12 ± 8 years versus 10 ± 7 years; P = 0.037, and the ratio of patients on metformin to those on combination therapy was higher in men (P = 0.018. Target glycemic response (1-year HbA1c ≤ 7% was achieved in a significantly higher proportion of males than females (38% versus 27%;Χ2 = 4.66; P = 0.03. Target weight loss expressed as 1-year weight percent fall from baseline ≥ 75th percentile (8.5% was significantly higher in females at 8 and 12 months (P < 0.05; for both. One-year glycemic target response was inversely related to baseline HbA1c levels and diabetes duration among males, while metformin therapy (compared to oral combination therapy was a significant predictor of better glycemic targets among females. Homeostasis model assessment-B, measured in 117 patients, predicted hypoglycemic

  14. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up

    Science.gov (United States)

    Kise, Nina Jullum; Risberg, May Arna; Stensrud, Silje; Ranstam, Jonas; Engebretsen, Lars; Roos, Ewa M

    2016-01-01

    Objective To determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears. Design Randomised controlled superiority trial. Setting Orthopaedic departments at two public hospitals and two physiotherapy clinics in Norway. Participants 140 adults, mean age 49.5 years (range 35.7–59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis. Interventions 12 week supervised exercise therapy alone or arthroscopic partial meniscectomy alone. Main outcome measures Intention to treat analysis of between group difference in change in knee injury and osteoarthritis outcome score (KOOS4), defined a priori as the mean score for four of five KOOS subscale scores (pain, other symptoms, function in sport and recreation, and knee related quality of life) from baseline to two year follow-up and change in thigh muscle strength from baseline to three months. Results No clinically relevant difference was found between the two groups in change in KOOS4 at two years (0.9 points, 95% confidence interval −4.3 to 6.1; P=0.72). At three months, muscle strength had improved in the exercise group (P≤0.004). No serious adverse events occurred in either group during the two year follow-up. 19% of the participants allocated to exercise therapy crossed over to surgery during the two year follow-up, with no additional benefit. Conclusion The observed difference in treatment effect was minute after two years of follow-up, and the trial's inferential uncertainty was sufficiently small to exclude clinically relevant differences. Exercise therapy showed positive effects over surgery in improving thigh muscle strength, at least in the short term. Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider supervised

  15. Radiation Therapy (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Radiation Therapy KidsHealth > For Parents > Radiation Therapy Print A ... have many questions and concerns about it. About Radiation Therapy In radiation therapy, high-energy radiation from ...

  16. The Inhaled Steroid Treatment As Regular Therapy in Early Asthma (START) study 5-year follow-up: effectiveness of early intervention with budesonide in mild persistent asthma

    DEFF Research Database (Denmark)

    Busse, William W; Pedersen, Søren; Pauwels, Romain A;

    2008-01-01

    BACKGROUND: The Inhaled Steroid Treatment as Regular Therapy in Early Asthma (START) study enrolled 7241 patients aged 5 to 66 years with recent-onset, mild persistent asthma to assess early intervention with the inhaled corticosteroid budesonide on long-term asthma control. OBJECTIVE: The open......-label phase of the START study was included to determine the effect on lung function and asthma control of adding budesonide to the reference group patients who had not initially received inhaled corticosteroids. METHODS: Patients were randomized to double-blind treatment with budesonide, 200 mug (those aged...... asthma therapy for 3 years, after which all patients received 2 years of open-label treatment with budesonide once daily. RESULTS: During the full 5-year study period, postbronchodilator FEV(1) percent predicted decreased, irrespective...

  17. Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results from a 2-Year Randomized Trial

    Science.gov (United States)

    Eack, Shaun M.; Hogarty, Gerard E.; Greenwald, Deborah P.; Hogarty, Susan S.; Keshavan, Matcheri S.

    2011-01-01

    Objective: To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method: Early course schizophrenia outpatients (N = 58) were randomly assigned to cognitive enhancement therapy (CET) or an enriched supportive therapy (EST) control and…

  18. Early changes in adipokine levels and baseline limb fat may predict HIV lipoatrophy over 2 years following initiation of antiretroviral therapy

    DEFF Research Database (Denmark)

    Calmy, A; Carey, D; Mallon, P W G

    2008-01-01

    BACKGROUND: No biological marker has been identified that predicts the development of lipodystrophy (LD). We investigated whether metabolic and body composition parameters could predict the development of LD over 2 years in adults initiating antiretroviral therapy (ART). METHODS: We used stored p...

  19. A Randomised Controlled Treatment Trial of Two Forms of Family Therapy in Adolescent Anorexia Nervosa: A Five-Year Follow-Up

    Science.gov (United States)

    Eisler, Ivan; Simic, Mima; Russell, Gerald F. M.; Dare, Christopher

    2007-01-01

    Background: There is growing evidence that family therapy is an effective treatment for adolescent anorexia nervosa. This study aimed to ascertain the long-term impact of two forms of outpatient family intervention previously evaluated in a randomised controlled trial (RCT). Method: A five-year follow-up was conducted on a cohort of 40 patients…

  20. Moments of Meeting: Difficulties and Developments in Shared Attention, Interaction, and Communication with Children with Autism during Two Years of Music Therapy in a Public Preschool Class

    Science.gov (United States)

    Barnes, Geoffrey Prescott

    2010-01-01

    Drawing upon video recordings over two years, teacher interviews, school reports, and field notes, this practitioner research study described and analyzed 16 video excerpts from a music therapy group in a public preschool class serving 14 children with autism, for durations ranging from two to sixteen months. The research centered on three of the…

  1. 用于硼中子俘获治疗的超热中子束理论设计%Theoretical design of an epithermal neutron beam for boron neutron capture therapy

    Institute of Scientific and Technical Information of China (English)

    张晓敏; 潘洁; 宁静; 谢向东; 杨国山

    2010-01-01

    Objective To design a scheme of epithermal neutron beam used for boron neutron capture therapy (BNCT).Methods Based on Tsinghua University experimental reactor and its No.1 passage,five schemes comprised of moderate materials,absorbing materials of thermal neutron and γ shielding materials were designed according to different locations of materials placed in No.1 passage.To select a proper scheme from five schemes,the neutron fluence rate,the neutron dose rate and γ dose rate at exit of beam in each scheme were calculated with Monte Carlo simulating methods and then contrasted with BNCT technique criterion.Results The scheme of epithermal neutron beam meeting technical requirements of BNCT was obtained,in which the thickness of moderate material,absorbing materials of thermal neutron and γ shielding materials are 53.5 cm,2 mm and 9 cm,respectively.Conclusions The theoretical scheme could provide some reference to realize BNCT on reactor.%目的 设计用于硼中子俘获治疗(BNCT)的超热中子束理论方案.方法 基于清华大学试验核反应堆,以其1号孔道为材料布放孔道,设计了由慢化材料、热中子吸收材料、γ屏蔽材料组成,但材料布放位置具有差异的5种理论方案;利用蒙特卡罗(MC)模拟方法,分别计算5种方案束出口处的中子注量率、剂量率及γ剂量率值,通过与BNCT技术指标对比,从5种方案中选择一种合适的方案.结果 得到了一个符合BNCT各项技术指标的超热中子束理论方案,其慢化材料厚度为53.5 cm、热中子吸收材料厚度为2 mm、γ屏蔽材料厚度为9 cm.结论 本研究给出的超热中子束理论方案为基于反应堆实现BNCT提供一定的理论参考.

  2. Marine turtle capture data

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — To estimate abundance, growth, and survival rate and to collect tissue samples, marine turtles are captured at nesting beaches and foraging grounds through various...

  3. The effect of visual therapy on the ocular motor control of seven- to eight-year-old children with developmental coordination disorder (DCD).

    Science.gov (United States)

    Coetzee, Dané; Pienaar, Anita E

    2013-11-01

    The aims of this study were to determine the extent of ocular, motor control problems and the effect of visual therapy on such problems, among seven- to eight-year-old children diagnosed with DCD. Thirty-two, children with a mean age of 95.66 months (SD ± 3.54) participated in the study. The MABC was used to classify children into DCD categories (motor control. A two-group pre-test-post-test, cross-over design was followed with a retention test two years, thereafter to determine the lasting effect of the visual therapy, intervention. The 18-week visual therapy programme was executed once a week, for 40 min during school hours, after which the two groups were, crossed over. Percentages of ocular motor control problems ranging, between 6.25% and 93.75% were found in both the groups before participating, in the visual therapy programme, with the highest percentage problems found, in visual pursuit with the left eye. Visual therapy contributed to a, significant improvement of 75-100% in visual pursuit, fixation, ocular, alignment and convergence, with significant lasting effects (pmotor control.

  4. Seamless presentation capture, indexing, and management

    Science.gov (United States)

    Hilbert, David M.; Cooper, Matthew; Denoue, Laurent; Adcock, John; Billsus, Daniel

    2005-10-01

    Technology abounds for capturing presentations. However, no simple solution exists that is completely automatic. ProjectorBox is a "zero user interaction" appliance that automatically captures, indexes, and manages presentation multimedia. It operates continuously to record the RGB information sent from presentation devices, such as a presenter's laptop, to display devices, such as a projector. It seamlessly captures high-resolution slide images, text and audio. It requires no operator, specialized software, or changes to current presentation practice. Automatic media analysis is used to detect presentation content and segment presentations. The analysis substantially enhances the web-based user interface for browsing, searching, and exporting captured presentations. ProjectorBox has been in use for over a year in our corporate conference room, and has been deployed in two universities. Our goal is to develop automatic capture services that address both corporate and educational needs.

  5. Feasibility evaluation of neutron capture therapy for hepatocellular carcinoma using selective enhancement of boron accumulation in tumour with intra-arterial administration of boron-entrapped water-in-oil-in-water emulsion

    Energy Technology Data Exchange (ETDEWEB)

    Yanagie, Hironobu, E-mail: yanagie@n.t.u-tokyo.ac.jp [Dept of Nuclear Engineering and Management, Graduate School of Engineering, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656 (Japan)] [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Kumada, Hiroaki [Proton Medical Research Center, University of Tsukuba, Ibaraki (Japan); Nakamura, Takemi [Japan Atomic Energy Research Institute, Ibaraki (Japan); Higashi, Syushi [Dept of Surgery, Ebihara Memorial Hospital, Miyazaki (Japan)] [Kyushu Industrial Sources Foundation, Miyazaki (Japan); Ikushima, Ichiro [Dept of Radiology, Miyakonojyo Metropolitan Hospital, Miyazaki (Japan); Morishita, Yasuyuki [Dept of Human and Molecular Pathology, Graduate School of Medicine, University of Tokyo, Tokyo (Japan); Shinohara, Atsuko [Dept of Humanities, Graduate School of Seisen University, Tokyo (Japan); Fijihara, Mitsuteru [SPG Techno Ltd. Co., Miyazaki (Japan); Suzuki, Minoru; Sakurai, Yoshinori [Research Reactor Institute, Kyoto University, Osaka (Japan); Sugiyama, Hirotaka [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Kajiyama, Tetsuya [Kyushu Industrial Sources Foundation, Miyazaki (Japan); Nishimura, Ryohei [Dept of Veternary Surgery, University of Tokyo Veternary Hospital, Tokyo (Japan); Ono, Koji [Research Reactor Institute, Kyoto University, Osaka (Japan); Nakajima, Jun; Ono, Minoru [Dept of Cardiothracic Surgery, University of Tokyo Hospital, Tokyo (Japan); Eriguchi, Masazumi [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan)] [Department of Surgery, Shin-Yamanote Hospital, Saitama (Japan); Takahashi, Hiroyuki [Dept of Nuclear Engineering and Management, Graduate School of Engineering, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656 (Japan)] [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan)

    2011-12-15

    Introduction: Hepatocellular carcinoma (HCC) is one of the most difficult to cure with surgery, chemotherapy, or other combinational therapies. In the treatment of HCC, only 30% patients can be operated due to complication of liver cirrhosis or multiple intrahepatic tumours. Tumour cell destruction in boron neutron-capture therapy (BNCT) is due to the nuclear reaction between {sup 10}B atoms and thermal neutrons, so it is necessary to accumulate a sufficient quantity of {sup 10}B atoms in tumour cells for effective tumour cell destruction by BNCT. Water-in-oil-in-water (WOW) emulsion has been used as the carrier of anti-cancer agents on intra-arterial injections in clinical. In this study, we prepared {sup 10}BSH entrapped WOW emulsion by double emulsifying technique using iodized poppy-seed oil (IPSO), {sup 10}BSH and surfactant, for selective intra-arterial infusion to HCC, and performed simulations of the irradiation in order to calculate the dose delivered to the patients. Materials and methods: WOW emulsion was administrated with intra-arterial injections via proper hepatic artery on VX-2 rabbit hepatic tumour models. We simulated the irradiation of epithermal neutron and calculated the dose delivered to the tissues with JAEA computational dosimetry system (JCDS) at JRR4 reactor of Japan Atomic Research Institute, using the CT scans of a HCC patient. Results and discussions: The {sup 10}B concentrations in VX-2 tumour obtained by delivery with WOW emulsion were superior to those by conventional IPSO mix emulsion. According to the rabbit model, the boron concentrations (ppm) in tumour, normal liver tissue, and blood are 61.7, 4.3, and 0.1, respectively. The results of the simulations show that normal liver biologically weighted dose is restricted to 4.9 Gy-Eq (CBE; liver tumour: 2.5, normal liver: 0.94); the maximum, minimum, and mean tumour weighted dose are 43.1, 7.3, and 21.8 Gy-Eq, respectively, in 40 min irradiation. In this study, we show that {sup 10}B

  6. Optimising iron chelation therapy with deferasirox for non-transfusion-dependent thalassaemia patients: 1-year results from the THETIS study.

    Science.gov (United States)

    Taher, Ali T; Cappellini, M Domenica; Aydinok, Yesim; Porter, John B; Karakas, Zeynep; Viprakasit, Vip; Siritanaratkul, Noppadol; Kattamis, Antonis; Wang, Candace; Zhu, Zewen; Joaquin, Victor; Uwamahoro, Marie José; Lai, Yong-Rong

    2016-03-01

    Efficacy and safety of iron chelation therapy with deferasirox in iron-overloaded non-transfusion-dependent thalassaemia (NTDT) patients were established in the THALASSA study. THETIS, an open-label, single-arm, multicentre, Phase IV study, added to this evidence by investigating earlier dose escalation by baseline liver iron concentration (LIC) (week 4: escalation according to baseline LIC; week 24: adjustment according to LIC response, maximum 30mg/kg/day). The primary efficacy endpoint was absolute change in LIC from baseline to week 52. 134 iron-overloaded non-transfusion-dependent anaemia patients were enrolled and received deferasirox starting at 10mg/kg/day. Mean actual dose±SD over 1year was 14.70±5.48mg/kg/day. At week 52, mean LIC±SD decreased significantly from 15.13±10.72mg Fe/g dw at baseline to 8.46±6.25mg Fe/g dw (absolute change from baseline, -6.68±7.02mg Fe/g dw [95% CI: -7.91, -5.45]; P<0.0001). Most common drug-related adverse events were gastrointestinal: abdominal discomfort, diarrhoea and nausea (n=6 each). There was one death (pneumonia, not considered drug related). With significant and clinically relevant reductions in iron burden alongside a safety profile similar to that in THALASSA, these data support earlier escalation with higher deferasirox doses in iron-overloaded non-transfusion-dependent anaemia patients.

  7. Capture myopathy in an endangered sandhill crane (Grus canadensis pulla)

    Science.gov (United States)

    Carpenter, J.W.; Thomas, N.J.; Reeves, S.

    1991-01-01

    Despite precautions to protect cranes, a 3-year-old endangered Mississippi sandhill crane (Grus canadensis pulla) was found caught in a leghold trap in Gautier, Mississippi, on 11 November 1987. The bird could have been in the trap for up to 16 hr and was standing and struggling to escape when it was discovered. Serum chemistries of the crane on 12 November revealed elevated lactic dehydrogenase (2,880 IU/L), alanine aminotransferase (ALT) (152 IU/L), and aspartate aminotransferase (AST) (>1,000 IU/L) values. Following surgical amputation of a fractured toe, the bird never attempted to stand and was unable to stand even when manually supported. Radiographic and physical examination of both legs did not reveal any anatomical abnormalities. Despite medical care, including supportive therapy, no improvement was observed in the bird's ability to stand and to support itself, and the bird died on 19 November. Serum chemistries and the postmortem and histopathologic findings were compatible with capture myopathy described in other species. Because of the possible susceptibility of long-legged birds such as the Mississippi sandhill crane to capture myopathy, special care must be taken when trapping, handling, chemically immobilizing, and transporting these species. In addition, precautions must be taken when conducting a predator-control program to ensure that nontarget wildlife are unlikely to encounter traps. Capture myopathy has only rarely been observed in wild birds, and this case represents the first report in a Mississippi sandhill crane.

  8. THE USE OF CHOSEN THERAPIES IN THE CHILDREN´S HOMES FOR CHILDREN UNDER 3 YEARS OF THEIR AGE

    Directory of Open Access Journals (Sweden)

    Peřinová Kateřina

    2013-12-01

    Full Text Available The report is focused on children´s homes for children with serious health and social problems. There are 33 these organisations in the Czech Republic. It is well known, that children living in these institutions from neonatal age, suffer lack of incentives. This fact has great influence to personality development. Therapies could help them to obtain more social contacts and experience with another environment. Scientific aim was to find out, if these institutions use special therapy to support children´s psychomotor development. The questionnaire was used for the research. The main result was found out if children´s homes use therapies.

  9. Three different patterns of CD4 recovery in a cohort of Chinese HIV patients following antiretroviral therapy - a five-year observational study.

    Science.gov (United States)

    Naftalin, Claire M; Wong, Ngai Sze; Chan, Denise P C; Wong, Ka Hing; Reidpath, Daniel D; Lee, Shui Shan

    2015-10-01

    To explore the heterogeneity of CD4 responses following highly active antiretroviral therapy, the patterns of CD4 recovery of HIV-1-infected Chinese patients who have been on their first antiretroviral regimen for ≥5 years were analysed. The CD4 trajectories were traced, smoothed and differentiated into three defined profiles. Half (56.3%) were 'satisfactory responders', with CD4 gain of >100 cells/μL and a peak of >350 cells/μL, plateauing before the end of Year 5. Thirty-three (24.4%) were 'continuing responders' whose CD4 rise persisted at Year 4-5. The remaining 26 (19.3%) were 'poor responders'. Presentation with AIDS before therapy was common not just among 'poor' but also paradoxically the 'continuing' responders. While a majority had responded well to antiretroviral therapy, older patients and those with AIDS diagnosis before initiation of therapy may never achieve a satisfactory level even with effective treatment. Categorization of HIV patients by their CD4 trajectory may support the prediction of immunological outcome over time, and ultimately inform treatment choices.

  10. Fishes’ composition and captured yield in Sentani Lake Papua

    Directory of Open Access Journals (Sweden)

    CHAIRULWAN UMAR

    2006-10-01

    Full Text Available Sentani lake is known as lake in Papua where biodiversity of fish is high and captured fisheries activities is dominantly found. The aim of this research was to know the fishes’ composition and captured yield in Sentani lake. This research was done in 2005 by using stratified sampling method which covered 7 (seven research stations. Data of fishes’ composition and captured yield were obtain from fishers’ captured and from experimental captured. The captured fish and relative abundance are 16 species. Captured yield in period of Mei – December 2005 was fluctuative (130.860 – 182.144 kg. The average was 151.960 kg. Total production a year was around 1.823, 52 ton/year in which fishers’ captured yield was around 4.2 – 5.6 kg/day with the average 4.7 kg/day.

  11. Cognitive function and neurodevelopmental outcomes in HIV-infected Children older than 1 year of age randomized to early versus deferred antiretroviral therapy: the PREDICT neurodevelopmental study.

    OpenAIRE

    Puthanakit, T.; Ananworanich, J.; Vonthanak, S.; Kosalaraksa, P; Hansudewechakul, R; Lugt, J. van der; Kerr, SJ; Kanjanavanit, S.; Ngampiyaskul, C.; Wongsawat, J; Luesomboon, W.; Vibol, U.; Pruksakaew, K; Suwarnlerk, T; Apornpong, T

    2013-01-01

    We previously reported similar AIDS-free survival at 3 years in children who were >1 year old initiating antiretroviral therapy (ART) and randomized to early versus deferred ART in the Pediatric Randomized to Early versus Deferred Initiation in Cambodia and Thailand (PREDICT) study. We now report neurodevelopmental outcomes.Two hundred eighty-four HIV-infected Thai and Cambodian children aged 1-12 years with CD4 counts between 15% and 24% and no AIDS-defining illness were randomized to initia...

  12. Current perspectives in stem cell therapy for spinal cord repair in humans: a review of work from the past 10 years

    Directory of Open Access Journals (Sweden)

    Eric Domingos Mariano

    2014-06-01

    Full Text Available Spinal cord injury (SCI and amyotrophic laterals sclerosis (ALS are devastating neurological conditions that affect individuals worldwide, significantly reducing quality of life, both for patients and their relatives. Objective : The present review aims to summarize the multiple restorative approaches being developed for spinal cord repair, the use of different stem cell types and the current knowledge regarding stem cell therapy. Method : Review of the literature from the past 10 years of human studies using stem cell transplantation as the main therapy, with or without adjuvant therapies. Conclusion : The current review offers an overview of the state of the art regarding spinal cord restoration, and serves as a starting point for future studies.

  13. Muon capture at PSI

    CERN Document Server

    Winter, Peter

    2010-01-01

    Measuring the rate of muon capture in hydrogen provides one of the most direct ways to study the axial current of the nucleon. The MuCap experiment uses a negative muon beam stopped in a time projection chamber operated with ultra-pure hydrogen gas. Surrounded by a decay electron detector, the lifetime of muons in hydrogen can be measured to determine the singlet capture rate Lambda_s to a final precision of 1%. The capture rate determines the nucleon's pseudoscalar form factor g_p. A first result, g_p = 7.3 +- 1.1, has been published and the final analysis of the full statistics will reduce the error by a factor of up to 3. Muon capture on the deuteron probes the weak axial current in the two-nucleon system. Within the framework of effective field theories the calculation of such two-nucleon processes involving the axial current requires the knowledge of one additional low energy constant which can be extracted from the doublet capture rate Lambda_d. The same constant then allows to model-independently calcu...

  14. Muon capture in deuterium

    Science.gov (United States)

    Ricci, P.; Truhlík, E.; Mosconi, B.; Smejkal, J.

    2010-06-01

    Model dependence of the capture rates of the negative muon capture in deuterium is studied starting from potential models and the weak two-body meson exchange currents constructed in the tree approximation and also from an effective field theory. The tree one-boson exchange currents are derived from the hard pion chiral Lagrangians of the NΔπρωa system. If constructed in conjunction with the one-boson exchange potentials, the capture rates can be calculated consistently. On the other hand, the effective field theory currents, constructed within the heavy baryon chiral perturbation theory, contain a low energy constant d that cannot be extracted from data at the one-particle level nor determined from the first principles. Comparative analysis of the results for the doublet transition rate allows us to extract the constant d.

  15. Extended disease-free interval of 6 years in a recurrent glioblastoma multiforme patient treated with G207 oncolytic viral therapy

    Directory of Open Access Journals (Sweden)

    Whisenhunt Jr TR

    2015-01-01

    Full Text Available Thomas R Whisenhunt Jr, Kiran F Rajneesh, James R Hackney, James M Markert Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA Background: Glioblastoma multiforme (GBM is a relentless primary central nervous system malignancy that remains resistant to conventional therapy despite major advances in clinical neurooncology. This report details the case of a patient who had failed conventional treatment for recurrent GBM and was ultimately treated with a genetically engineered herpes simplex virus (HSV type 1 vector, G207. Methods: Case report detailing the outcomes of one patient enrolled into the gene therapy arm of the Neurovir G207 protocol whereby stereotactic injection of 120 µL G207 viral suspension containing 1×107 plaque-forming units (or active viral particles was made into the enhancing region of the tumor. Results: In this patient, despite aggressive surgical resection, adjuvant radiotherapy and chemotherapy, tumor progression occurred. However, with G207 oncolytic therapy and brief exposures to second and third treatments, this patient had an extended survival time of 7.5 years and a 6-year apparent disease-free interval, an extraordinarily unusual finding in the pretemozolomide era. Conclusion: With minimal adjunctive chemotherapy, including one course of temozolomide, one course of procarbazine, and four cycles of irinotecan, the patient survived over 7 years before the next recurrence. Addition of G207 to this patient’s traditional therapy may have been the critical treatment producing her prolonged survival. This report demonstrates the potential for long-term response to a one-time treatment with oncolytic HSV and encourages continued research on oncolytic viral therapy for GBM. Keywords: oncolytic virotherapy, malignant glioma, tumor, herpes simplex, HSV-1, immunotherapy

  16. US Spacesuit Knowledge Capture

    Science.gov (United States)

    Chullen, Cinda; Thomas, Ken; McMann, Joe; Dolan, Kristi; Bitterly, Rose; Lewis, Cathleen

    2011-01-01

    The ability to learn from both the mistakes and successes of the past is vital to assuring success in the future. Due to the close physical interaction between spacesuit systems and human beings as users, spacesuit technology and usage lends itself rather uniquely to the benefits realized from the skillful organization of historical information; its dissemination; the collection and identification of artifacts; and the education of those in the field. The National Aeronautics and Space Administration (NASA), other organizations and individuals have been performing United States (U.S.) Spacesuit Knowledge Capture since the beginning of space exploration. Avenues used to capture the knowledge have included publication of reports; conference presentations; specialized seminars; and classes usually given by veterans in the field. More recently the effort has been more concentrated and formalized whereby a new avenue of spacesuit knowledge capture has been added to the archives in which videotaping occurs engaging both current and retired specialists in the field presenting technical scope specifically for education and preservation of knowledge. With video archiving, all these avenues of learning can now be brought to life with the real experts presenting their wealth of knowledge on screen for future learners to enjoy. Scope and topics of U.S. spacesuit knowledge capture have included lessons learned in spacesuit technology, experience from the Gemini, Apollo, Skylab and Shuttle programs, hardware certification, design, development and other program components, spacesuit evolution and experience, failure analysis and resolution, and aspects of program management. Concurrently, U.S. spacesuit knowledge capture activities have progressed to a level where NASA, the National Air and Space Museum (NASM), Hamilton Sundstrand (HS) and the spacesuit community are now working together to provide a comprehensive closed-looped spacesuit knowledge capture system which includes

  17. Safety and effectiveness of the Genous™ endothelial progenitor cell-capture stent in the first year following ST-elevation acute myocardial infarction: A single center experience and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Pereira-da-Silva, Tiago, E-mail: tiagopsilva@sapo.pt; Bernardes, Luís; Cacela, Duarte; Fiarresga, António; Sousa, Lídia; Patrício, Lino; Ferreira, Rui Cruz

    2013-11-15

    Purpose: The Genous™ stent (GS) is designed to accelerate endothelization, which is potentially useful in the pro-thrombotic environment of ST-elevation acute myocardial infarction (STEMI). We aimed to evaluate the safety and effectiveness of the GS in the first year following primary percutaneous coronary intervention (PCI) and to compare our results with the few previously published studies. Methods and Materials: All patients admitted to a single center due to STEMI that underwent primary PCI using exclusively GS, between May 2006 and January 2012, were enrolled. The primary study endpoints were major adverse cardiac events (MACEs), defined as the composite of cardiac death, acute myocardial infarction and target vessel revascularization, at one and 12 months. Results: In the cohort of 109 patients (73.4% male, 59 ± 12 years), 24.8% were diabetic. PCI was performed in 116 lesions with angiographic success in 99.1%, using 148 GS with median diameter of 3.00 mm (2.50–4.00) and median length of 15 mm (9–33). Cumulative MACEs were 2.8% at one month and 6.4% at 12 months. Three stent thromboses (2.8%), all subacute, and one stent restenosis (0.9%) occurred. These accounted for the four target vessel revascularizations (3.7%). At 12 months, 33.9% of patients were not on dual antiplatelet therapy. Conclusions: GS was safe and effective in the first year following primary PCI in STEMI, with an apparently safer profile comparing with the previously published data. Summary: We report the safety and effectiveness of the Genous™ stent (GS) in the first year following primary percutaneous coronary intervention in ST-elevation acute myocardial infarction. A comprehensive review of the few studies that have been published on this subject was included and some suggest a less safe profile of the GS. Our results and the critical review included may add information and reinforce the safety and effectiveness of the GS in ST-elevation in acute myocardial infarction.

  18. 硼中子俘获疗法诱导U87胶质瘤细胞凋亡%Boron neutron capture therapy inducing apoptosis in U87 glioblastoma cells

    Institute of Scientific and Technical Information of China (English)

    王鹏; 章翔; 江新标; 程光; 赵英; 曹锐峰; 刘红; 王剑博

    2009-01-01

    目的 探讨硼中子俘获疗法(BNCT)对人脑胶质瘤细胞株U87的增殖抑制和诱导凋亡的作用及可能机制.方法 实验分为未照射组(0 Gy)、γ射线对照组(4、8 Gy)、反应堆组(3.5 Gy)、BNCT组(4、8 Gy).采用形态观察、流式细胞仪Annexin V/PI荧光染色、四甲基偶氮唑蓝(MTT)法等方法观察BNCT对U87细胞的增殖抑制和诱导凋亡的作用,以免疫组织化学技术检测P53蛋白的表达,应用western blot检测BCL-2、BAX蛋白表达的变化.结果 硼中子照射后细胞出现典型的凋亡形态改变.BNCT 4、8 Gy组处理后48 h细胞的凋亡率分别为65.1%、85.9%.BNCT 4、8 Gy组细胞生长抑制作用显著高于同等剂量的γ射线照射组(P<0.01).未照射的U87细胞P53蛋白表达阴性,BNCT4、8 Gy照射后P53蛋白表达阳性.BNCT4、8 Gy照射后BCL-2蛋白表达下降,BAX蛋白上升.结论 BNCT对U87细胞具有显著的增殖抑制作用,并有剂量、时间依赖性特点.%Objective To explore the effect of boron neutron capture therapy(BNCT)on human brain glioma U87 cell line and its mechanisms.Method U87 cells in exponential phase were divided into 6 groups:untreated control,60Co γ 4 Gy,60Co γ 8 Gy,nuclear reactor exposure without boronophenylalanine (BPA)3.5 Gy,BNCT 4 Gy and BNCT 8 Gy.The anti-tumor effects were analyzed through cell morphology,the Annexin V/PI assay by flow cytometer(FCM),and methyl thiazolyl tetrazolium(MTT)assay.The expression of P53 protein was studied by immunocytochemistry and the expression of BCL-2 protein and BAX protein were measured by western blot.Results Typical morphological changes were observed after BNCT irradiation.The apoptotic rates were observed 48 h after irradiation with 65.1%and 85.9%for BNCT 4 Gy and 8 Gy.BNCT showed higher apoptotic rates than those of γ-ray control irradiation (P<0.01).The expression level of P53 protein was negative in U87,while positive expression of P53 protein was observed in BNCT 4 Gy and 8 Gy groups

  19. Tratamiento del cáncer por captura neutrónica de boro: Su aplicación al carcinoma indiferenciado de tiroides Boron neutron capture therapy applied to undifferentiated thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Mario A. Pisarev

    2006-12-01

    Full Text Available El cáncer indiferenciado de tiroides es un tumor muy agresivo, de muy mal pronóstico y sin tratamiento efectivo. La terapia por captura neutrónica de boro (BNCT podría ser una alternativa para el tratamiento de esta enfermedad. Se basa en la captación selectiva de boro por el tumor y su activación por un haz de neutrones. El boro activado libera un núcleo de litio-7 y una partícula alfa, las cuales tienen una alta transmisión linear de energía (linear energy transfer, LET y un alcance de 5-9 µm, destruyendo el tumor. En estudios previos hemos mostrado que la línea celular humana de cáncer indiferenciado de tiroides (ARO tiene una captación selectiva de borofenilalanina (10BPA tanto in vitro como después de ser implantada en ratones NIH nude. También demostramos en estos animales inyectados con BPA e irradiados con un haz de neutrones térmicos, un 100% de control sobre el crecimiento tumoral y un 50% de cura histológica. En trabajos posteriores mostramos que la porfirina 10BOPP tetrakis-carborane carboxylate ester de 2,4-bis-(a,b-dihydroxyethyl-deutero-porphyrin IX cuando es inyectada 5-7 días antes que el BPA se obtiene una concentración tumoral de boro de aproximadamente el doble que el BPA solo (45-38 ppm vs. 20 ppm. La posterior irradiación con neutrones mostró un 100% de remisión completa en animales con tumores cuyo volumen pre-tratamiento era de 50 mm³ o menor. Los perros padecen CIT espontáneo, con un comportamiento biológico similar al humano, y una captación selectiva de BPA, abriendo la posibilidad de su tratamiento por BNCT.Undifferentiated thyroid carcinoma (UTC is an aggressive tumor with a poor prognosis due to the lack of an effective treatment. Boron neutron capture therapy (BNCT is based on the selective uptake of boron by the tumor and its activation by a neutron beam, releasing lithium-7 and an alpha particle that will kill the tumor cells by their high linear energy transfer (LET. In previous

  20. Studies on preparation of folate-targeted boron liposomes as potential delivery agents for neutron capture therapy%叶酸靶向含硼脂质体的制备及其包封率的测定

    Institute of Scientific and Technical Information of China (English)

    王志会; 钱林学; 刘冬

    2012-01-01

    To prepare folate-targeted liposomes with high encapsulation efficiency is an effective targeted drug delivery agent for boron neutron capture therapy (BNCT). The double emulsion method is used to prepare liposomes. The combination of thin film hydration and ultrasonic dispersion method is used to prepare liposomes loaded with HBA,TBA or BBA. The content and the encapsulation efficiency of HBA,TBA or BBA liposomes are evaluated by high performance liquid chromatography ( HPLC). As the basis of the encapsulation efficiency, the optimal conditions for preparing liposomes were explored by the single factor method. The optimal chromatographic conditions of the three drugs were filtered out. They had a good linear relation in a range of 1 ~ 100 μg/mL. The encapsulation efficiency of HBA, TBA and BBA liposomes were 25. 7 % , 38. 9 % and 94. 8 % at the optimal preparation and condition. The optimal conditions for preparing BBA liposomes are as follows; the mass ratio of cholesterol and phospholipid is 1: 1, the ratio of drug and lipid is 1: 50 and the optimal pH value is 7. 4. The entrapment efficiency for BBA liposomes in the optimal groups reached 94. 8 % . The technique of preparing folate-tar-geted liposomes is feasible and the method of quality control is simple and high accuracy. The liposomes appeare to be round, and well separated with high entrapment efficiency.%制备具有良好靶向性及包封率高的硼脂质体,为硼中子俘获治疗方法的研究与应用建立了一个有效的靶向给药途径.采用复乳法及薄膜—超声分散法制备叶酸靶向硼脂质体,利用高效液相色谱法检测4—羟基苯硼酸4—Hydroxyphenylboronicacid (HBA)脂质体、2—噻吩硼酸2—thiophenylboric acid(TBA)脂质体、4—叔丁基苯硼酸4—tert-Butylphenylboronic Acid(BBA)脂质体的含量及包封率,以包封率为评价指标,采用单因素法优化脂质体的制备处方和工艺条件.筛选出HBA、TBA、BBA最优的色谱条件,分

  1. Survival of multiple myeloma patients in the era of novel therapies confirms the improvement in patients younger than 75 years: a population-based analysis.

    Science.gov (United States)

    Pozzi, Samantha; Marcheselli, Luigi; Bari, Alessia; Liardo, Eliana V; Marcheselli, Raffaella; Luminari, Stefano; Quaresima, Micol; Cirilli, Claudia; Ferri, Paola; Federico, Massimo; Sacchi, Stefano

    2013-10-01

    Novel treatments for multiple myeloma (MM) have shown promising results in clinical trials, but the advantage in unselected patients is still unclear. In order to evaluate whether novel therapies impact survival of MM patients, we performed a population-based analysis on data collected by the Modena Cancer Registry from 1989 to 2009. The analysis evaluated 1206 newly diagnosed MM patients collected in the years 1988-96 (conventional therapy), 1997-05 (high dose melphalan and autologous transplant), and 2006-09 (novel agents era). Both relative survival (RS) and overall survival (OS) improved over the years, but not equally in the three groups. For patients aged survival of MM patients aged survival. Despite the limits of this study, these data refer to an unselected population, giving a picture of every day clinical practice.

  2. Optimizing the radiation therapy dose prescription for pediatric medulloblastoma: Minimizing the life years lost attributable to failure to control the disease and late complication risk

    DEFF Research Database (Denmark)

    Brodin, N. Patrik; Vogelius, Ivan R.; Bjork-Eriksson, Thomas;

    2014-01-01

    Background. A mathematical framework is presented for simultaneously quantifying and evaluating the trade-off between tumor control and late complications for risk-based radiation therapy (RT) decision-support. To demonstrate this, we estimate life years lost (LYL) attributable to tumor recurrence...... is important, with 0.75 LYL (95% CI 0.60-7.2 years) for standard uniform 24 Gy CS irradiation. However, recurrence risk dominates the total LYL with 14.2 years (95% CI 13.4-16.6 years). Compared to standard treatment, a risk-adapted strategy prescribing 12 Gy to the spinal volume encompassing the 1st-10th...... thoracic vertebrae (Th1-Th10), and 36 Gy to the remaining CS volume, estimated a LYL reduction of 0.90 years (95% CI -0.18-2.41 years). Proton therapy with 36 Gy to the whole CS volume was associated with significantly fewer LYL compared to the risk-adapted photon strategies, with a mean LYL difference...

  3. Implementation of tomo-therapy in France: clinic results over two years; Mise en oeuvre de la tomotherapie en France: resultats cliniques a deux ans

    Energy Technology Data Exchange (ETDEWEB)

    Giraud, P.; Yassa, M. [Hopital europeen Georges-Pompidou, 75 - Paris (France); Giraud, P.; Zefkili, S.; Campana, F. [Institut Curie, 75 - Paris (France); Kantor, G.; Dejean, C. [Institut Bergonie, 33 - Bordeaux (France); Lisbona, A.; Mahe, M.A. [Centre Rene-Gauducheau, 44 - Nantes (France)

    2010-10-15

    As three French centres (Curie Institute in Paris, Bergonie Institute in Bordeaux, and Rene-Gauducheau centre in Nantes) have been equipped with helical tomo-therapy in 2007, the authors discuss the results obtained after two years of operation. More than six hundred patients have been treated, mainly for head or neck, central nervous system, thorax, pelvic and abdominal cavity, and bone tumours. Session durations, acute toxicity rates, and toxicity effects are discussed. Short communication

  4. Nucleoside analogue therapy following one-year course of hepatitis B immunoglobulin in preventing hepatitis B virus reactivation after living donor liver transplantation.

    Science.gov (United States)

    Kawagishi, Naoki; Takeda, Ikuo; Miyagi, Shigehito; Satoh, Kazushige; Akamatsu, Yorihiro; Sekiguchi, Satoshi; Satomi, Susumu

    2010-12-01

    The combination therapy with hepatitis B immunoglobulin (HBIG) and nucleoside analogue is well tolerated for the hepatitis B recipients after liver transplantation, but its cost is an important problem in these days. Here we report the efficacy of nucleoside analogue therapy following one-year course of HBIG plus nucleoside analogue after living donor liver transplantation (LDLT). Out of 103 LDLTs, we selected 14 recipients who received the post-transplant therapy against reactivation of hepatitis B virus for more than 30 months. Those were eight patients with chronic hepatitis B, three with fulminant hepatitis, and three whose donors were positive for antibody to HB core antigen (HBc). During two days after the operation, HBIG (40,000 units) was administered, and the serum level of antibody to HB surface antigen (HBs) was maintained at around 150 IU/L for one year by monthly administration of HBIG. After one year, HBIG was withdrawn. A nucleoside analogue was administered daily from just after LDLT, and it was continued up to the present. Among the 14 patients, two recipients had recurrence of hepatitis B. Three patients, including one patient with recurrence of hepatitis B, died due to hepatocellular carcinoma or its associated cirrhosis; namely, their deaths are unrelated to hepatitis B-related diseases. The remaining 11 patients are leading normal lives. In conclusion, nucleoside analogue therapy after one-year course of HBIG plus nucleoside analogue is feasible and cost-effective in preventing HBV reactivation. But the patients are still at risk of breakthrough and some patients may need continued prophylaxis with HBIG.

  5. One-Year Follow-Up of the Effectiveness of Cognitive Behavioral Group Therapy for Patients’ Depression: A Randomized, Single-Blinded, Controlled Study

    OpenAIRE

    Kai-Jo Chiang; Tsai-Hui Chen; Hsiu-Tsu Hsieh; Jui-Chen Tsai; Keng-Liang Ou; Kuei-Ru Chou

    2015-01-01

    The aim of the study was to investigate the long-term (one year) effectiveness of a 12-session weekly cognitive behavior group therapy (CBGT) on patients with depression. This was a single-blind randomized controlled study with a 2-arm parallel group design. Eighty-one subjects were randomly assigned to 12 sessions intervention group (CBGT) or control group (usual outpatient psychiatric care group) and 62 completed the study. The primary outcome was depression measured with Beck Depression In...

  6. Radiation Therapy Improves Survival Outcome in Pancreatic Adenocarcinoma: Comparison of a 15-Year Institutional Experience at the University of Nebraska Medical Center with SEER Data

    OpenAIRE

    Baine, Michael J.; Chi Lin

    2014-01-01

    Objectives. We examined the role of radiation therapy (RT) in pancreatic adenocarcinoma (PA) treatment through a 15-year retrospective analysis of patients treated at University of Nebraska Medical Center (UNMC) as well as those from the SEER database. Methods. A total of 561 patients diagnosed with PA at UNMC between 1995 and 2011 and 60,587 patients diagnosed between 1995 and 2009 from the SEER were included. Examined prognostic factors for overall survival (OS) were age, gender, race, stag...

  7. CORRIGENDUM to Four Thrombotic Events Over 5 Years, Two Pulmonary Emboli and Two Deep Venous Thrombosis, When Testosterone-HCG Therapy Was Continued Despite Concurrent Anticoagulation in a 55-Year-Old Man With Lupus Anticoagulant

    Science.gov (United States)

    2017-01-01

    Owing to errors made by the authors, Charles J. Glueck, Kevin Lee, Marloe Prince, Vybhav Jetty, Parth Shah, and Ping Wang, the following article contains errors. Glueck CJ, Lee K, Prince M, et al. Four Thrombotic Events Over 5 Years, Two Pulmonary Emboli and Two Deep Venous Thrombosis, When Testosterone-HCG Therapy Was Continued Despite Concurrent Anticoagulation in a 55-Year-Old Man With Lupus Anticoagulant. J Investig Med High Impact Case Rep. 2016;4(3):1-6. doi: 10.1177/2324709616661833 PMID:28321420

  8. Advances in induced pluripotent stem cells, genomics, biomarkers, and antiplatelet therapy highlights of the year in JCTR 2013.

    Science.gov (United States)

    Barbato, Emanuele; Lara-Pezzi, Enrique; Stolen, Craig; Taylor, Angela; Barton, Paul J; Bartunek, Jozef; Iaizzo, Paul; Judge, Daniel P; Kirshenbaum, Lorrie; Blaxall, Burns C; Terzic, Andre; Hall, Jennifer L

    2014-07-01

    The Journal provides the clinician and scientist with the latest advances in discovery research, emerging technologies, preclinical research design and testing, and clinical trials. We highlight advances in areas of induced pluripotent stem cells, genomics, biomarkers, multimodality imaging, and antiplatelet biology and therapy. The top publications are critically discussed and presented along with anatomical reviews and FDA insight to provide context.

  9. Still Subversive after All These Years: The Relevance of Feminist Therapy in the Age of Evidence-Based Practice

    Science.gov (United States)

    Brown, Laura S.

    2006-01-01

    In this article, based on my Carolyn Wood Sherif Memorial Award Address, I address questions of the viability of feminist practice in the current zeitgeist. Using the framework of responding to questions raised by doctoral students about feminist therapy, I address how feminist practice aligns with the evidence-based practice movement,…

  10. Respiratory care year in review 2010: part 2. Invasive mechanical ventilation, noninvasive ventilation, pediatric mechanical ventilation, aerosol therapy.

    Science.gov (United States)

    Macintyre, Neil R; Nava, Stefano; Diblasi, Robert M; Restrepo, Ruben D; Hess, Dean R

    2011-05-01

    The purpose of this paper is to review the recent literature related to invasive mechanical ventilation, NIV, pediatric mechanical ventilation, and aerosol therapy. Topics covered related to invasive mechanical ventilation topics include the role of PEEP in providing lung protection during mechanical ventilation, unconventional modes for severe hypoxemia, and strategies to improve patient-ventilator interactions. Topics covered related to NIV include real-life NIV use, NIV and extubation failure, and NIV and pandemics. For pediatric mechanical ventilation, the topics addressed are NIV, invasive respiratory support, and inhaled nitric oxide. Topics covered related to aerosol therapy include short-acting β-adrenergic agents, long-acting β-adrenergic agents, long-acting antimuscarinic agents, inhaled corticosteroid therapy, phosphodiesterase type 4 (PDE4) inhibitors, long-acting β-adrenergic plus inhaled corticosteroid, long-acting antimuscarinic plus inhaled corticosteroid, nebulized hypertonic saline, inhaled mannitol, and inhaled antibiotic therapy. These topics were chosen and reviewed in a manner that is most likely to have interest to the readers of Respiratory Care.

  11. Outcome of Childhood Acute Lymphoblastic Leukaemia after Induction Therapy --- Three-Year Experience in a Tertiary Care Hospital in Bangladesh

    Directory of Open Access Journals (Sweden)

    M Belayet Hossain

    2017-01-01

    Full Text Available Background: The incidence of different malignancies is increasing among the world populations. Acute lymphoblastic leukaemia (ALL is the most common of all the paediatric malignancies. Response to induction therapy is one of the most important predictors of long term outcome of ALL. Objective: To see the immediate outcome of paediatric ALL patients following induction therapy. Materials and Methods: This retrospective study was conducted from January 2013 to December 2015. Total 221 paediatric ALL patients were included in this study. Diagnosis was based on history, examination, blast cells count on peripheral blood film and bone marrow study, CSF study and immunophenotyping of peripheral blood/bone marrow aspirate in patients who were financially capable. Among them, parents of 40 (18% patients did not agree to start chemotherapy. According to Modified UK ALL 2003 protocol (Regimen A & B 181 patients were given induction therapy (vincristine, prednisolone, L-asparaginase, and daunomycin in high risk patients. Among them 14 patients discontinued, 10 patients died during chemotherapy and rest 157 patients completed induction phase. Bone marrow study was repeated after completion of induction therapy and remission pattern was seen. Results: Out of 157 chemotherapy completed patients, 137 (87% went into complete remission (25% blast cells in the bone marrow. Ten (5.5% patients died due to bleeding, febrile neutropenia and sepsis during the course of induction therapy. Conclusion: ALL in children is curable with effective chemotherapy. Poverty, ignorance and misconception regarding outcome are responsible for refusal and discontinuation of chemotherapy in third world countries like Bangladesh. Mortality and treatment cost can be reduced with the improvement of the facilities for isolation, barrier nursing and supportive treatment, and by creating awareness.

  12. [A retrospective study on HBsAg clearance rate after antiviral therapy in children with HBeAg-positive chronic hepatitis B aged 1-7 years].

    Science.gov (United States)

    Zhu, S S; Dong, Y; Xu, Z Q; Wang, L M; Chen, D W; Gan, Y; Wang, F C; Yan, J G; Cao, L L; Wang, P; Zhang, H F

    2016-10-20

    Objective: To investigate the HBsAg clearance rate after antiviral therapy in children with HBeAg-positive chronic hepatitis B (CHB) aged 1-7 years. Methods: A retrospective analysis was performed for the HBsAg clearance rate in 293 children who were hospitalized in 302 Hospital of PLA from June 2006 to December 2013, met the inclusion criteria, received antiviral therapy, and were followed up for at least 6 months after the withdrawal of antiviral therapy. The t-test or the rank sum test was applied according to the distribution of continuous data, and the chi-square test was used for comparison of categorical data. Results: The HBsAg positive rate of children's mothers was 91.1%. In the age groups of >1-≤2 years, >2-≤3 years, >3-≤4 years, >4-≤5 years, >5-≤6 years, and >6-≤7 years, the HBsAg clearance rates were 66.1%, 65.5%, 45.7%, 41.3%, 20.6%, and 27.6%, respectively. There were significant differences in HBsAg clearance rate between the age groups of >1-≤3 years and >3-≤5 years, >1-≤3 years and >5-≤7 years, and >3-≤5 years and >5-≤7 years (P = 0.001, 0.000, and 0.008). Of all children, 64.8% were boys, among whom 41.1% achieved HBsAg clearance, and 35.2% were girls, among whom 61.2% achieved HBsAg clearance; there was a significant difference in HBsAg clearance rate between boys and girls (P = 0.001). The children with pretreatment alanine aminotransferase (ALT) levels of ≤80 IU/L, > 80 IU/L, ≤200 IU/L, and > 200 IU/L had HBsAg clearance rates of 40.7%, 51.2%, 47.6%, and 49.4%, respectively; there were no significant differences in HBsAg clearance rate between the ALT ≤80 IU/L and ALT > 80 IU/L groups and the ALT ≤200 IU/L and ALT > 200 IU/L groups (P = 0.101 and 0.778). There was no significant difference in HBsAg clearance rate between the pretreatment HBV DNA load clearance rate of 57.1%, and 85% had genotype C and an HBsAg clearance rate of 39.5%; there was no significant difference in HBsAg clearance rate between the

  13. Four-Year Durability of Initial Combination Therapy with Sitagliptin and Metformin in Patients with Type 2 Diabetes in Clinical Practice; COSMIC Study.

    Directory of Open Access Journals (Sweden)

    Eu Jeong Ku

    Full Text Available We investigated the efficacy of initial combination therapy with sitagliptin and metformin in patients with type 2 diabetes for 4 years in clinical practice.Between 2009 and 2010, we reviewed 1,178 patients with type 2 diabetes (HbA1c ≥7.5% or 58 mmol/mol prescribed initial combination therapy with sitagliptin and metformin. After excluding 288 patients without a second follow-up, 890 individuals (age, 58.0 ± 12.5 years; BMI, 25.4 ± 3.5 kg/m2; HbA1c, 8.6 ± 1.1% were followed up with every 3-6 months for 4 years. Homeostasis model assessments for insulin resistance and β-cell function (HOMA-β were recorded at baseline. The response criterion was HbA1c reduction by ≥0.8% from baseline or attainment of the target HbA1c (≤7.0% or 53 mmol/mol. At the end of every year of treatment, changes in HbA1c from the baseline were assessed.After 1 year, 72.2% of patients with initial combination therapy had responded, defined as HbA1c reduction ≥0.8% or attainment of the target HbA1c ≤7.0%. After 4 years, 35.4% of the patients still showed a response, with an HbA1c level of 7.0 ± 0.9%. A high HbA1c level at baseline was the most significant independent predictor of the long-term response (P<0.001. In addition, low HOMA-β was a significant predictor of a greater reduction in HbA1c. This treatment was generally well tolerated over the 4-year follow-up period, without any serious adverse events.This real-world follow-up study shows a persistent glucose-reducing effect of initial combination therapy with sitagliptin and metformin for up to 4 years.

  14. Management of the Class III malocclusion treated with maxillary expansion, facemask therapy and corrective orthodontic. A 15-year follow-up.

    Science.gov (United States)

    Almeida, Renato Rodrigues de; Alessio, Luiz Eduardo; Almeida-Pedrin, Renata Rodrigues de; Almeida, Marcio Rodrigues de; Pinzan, Arnaldo; Vieira, Luiz Sérgio

    2015-01-01

    The facial growth of Class III malocclusion worsens with age, in this case, the early orthopedic treatment, providing facial balance, modifying the maxillofacial growth and development. A 7.6-year old boy presented with Class III malocclusion associated with anterior crossbite; the mandible was shifted to the right and the maxilla had a transversal deficiency. Rapid maxillary expansion followed by facemask therapy was performed, to correct the anteroposterior relationship and improve the facial profile. The patient was followed for a 15-year period, after completion of the treatment, and stability was observed. Growing patients should be monitored following their treatment, so as to prevent malocclusion relapse.

  15. Favourable course of disease after incomplete remission on {sup 131}I therapy in children with pulmonary metastases of papillary thyroid carcinoma: 10 years follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Biko, Johannes; Reiners, Christoph; Kreissl, Michael C.; Verburg, Frederik A. [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Demidchik, Yuri [Thyroid Cancer Centre, Minsk (Belarus); Drozd, Valentina [International Belarussian-German Foundation, Minsk (Belarus)

    2011-04-15

    The aim of this study is to report on a collective of 20 children from Belarus who had developed papillary thyroid carcinoma with pulmonary metastases after the Chernobyl disaster. In all children fractionated radioiodine therapy (RIT) was ceased before achieving complete remission due to a lack of further effects of {sup 131}I therapy and an increased risk of pulmonary fibrosis. The 20 children (12 girls) were treated with {sup 131}I using 50 MBq/kg body weight for thyroid remnant ablation and 100 MBq/kg for further therapy in intervals of 5-12 months. After five to six courses and a cumulative activity of about 24 GBq {sup 131}I no further RIT was conducted; the median thyroglobulin (TG) was 56 {mu}g/l at this time. All patients were followed for at least 10 years after cessation of RIT using diagnostic whole-body scintigraphy, CT of the chest, lung function testing and stimulated TG measurements every 1-3 years. During follow-up after the last RIT a continuous decline of values for TG levels of {proportional_to}35% per year was observed between individual visits. The median Tg level at the time of cessation of {sup 131}I therapy was 56 {mu}g/l; however, at the last visit 16 of 20 patients had a TG level {<=}10 {mu}g/l (median 2.4 {mu}g/l). Neither on diagnostic radioiodine whole-body scan nor on CT was progression of lung metastases observed. No significant pulmonary fibrosis developed. In spite of incomplete remission of thyroid cancer at cessation of RIT, a continuing spontaneous decline of TG and clinically stable partial remissions were observed in this collective of children. Therefore, if RIT does not show further effects, the administration of further courses should be handled restrictively. (orig.)

  16. [Follow-up of surgical therapy in patients with threatened and acute myocardial ischemia for an average of 5 years].

    Science.gov (United States)

    Brunke, W; Anders, G; Müller, J H; Abet, U

    1990-11-01

    Out of a total group of 300 patients after local intracoronary fibrinolysis, systemic ultra-high short-term fibrinolysis and instable angina pectoris 73 (24% out of 300) patients, in whom acutely or in the course of the treatment a surgical therapy of their coronary heart disease was performed, were analysed. Constellations of the findings of the coronary heart disease, when according to this connection with an adequate conservative therapy on the basis of a diagnostic and therapeutic step programme in 44% of the patients an improvement of the load capacity and in 73% an improvement of the subjective well-being is to be stated. In patients with diseases of one vessel compared with patients with diseases of several vessels significantly more frequently an intraindividual increase of the bicycle-ergometric performance develops.

  17. Acute Renal Replacement Therapy in Children with Diarrhea-Associated Hemolytic Uremic Syndrome: A Single Center 16 Years of Experience

    OpenAIRE

    Silviu Grisaru; Morgunov, Melissa A.; Samuel, Susan M.; Julian P Midgley; Wade, Andrew W; Tee, James B.; Hamiwka, Lorraine A.

    2011-01-01

    Acute kidney injury (AKI) is becoming more prevalent among hospitalized children, its etiologies are shifting, and new treatment modalities are evolving; however, diarrhea-associated hemolytic uremic syndrome (D+HUS) remains the most common primary disease causing AKI in young children. Little has been published about acute renal replacement therapy (ARRT) and its challenges in this population. We describe our single center's experience managing 134 pediatric patients with D+HUS out of whom 5...

  18. Supernova electron capture rates

    CERN Document Server

    Martínez-Pinedo, G

    1999-01-01

    We have calculated the Gamow-Teller strength distributions for the ground states and low lying states of several nuclei that play an important role in the precollapse evolution of supernova. The calculations reproduce the experimental GT distributions nicely. The GT distribution are used to calculate electron capture rates for typical presupernova conditions. The computed rates are noticeably smaller than the presently adopted rates. The possible implications for the supernova evolution are discussed.

  19. Capture Matrices Handbook

    Science.gov (United States)

    2014-04-01

    changing the affinity ligand, we can use capture matrices to detect other chemicals such as chlorinated solvents, nerve and blister agents, pesticides...require significant chemical additives and complex equipment, generate a large secondary waste stream, and are difficult to automate. Magnetically...secondary wastes . 2 Other advantages are a large active surface area for a given mass of particles; the ability to process a solution that

  20. Cardiac function in growth hormone deficient patients before and after 1 year with replacement therapy: a magnetic resonance imaging study

    DEFF Research Database (Denmark)

    Andreassen, Mikkel; Faber, Jens Oscar; Petersen, Claus Leth;

    2011-01-01

    Assessed by conventional echocardiography the influence of growth hormone deficiency (GHD) and effects of replacement therapy on left ventricle (LV) function and mass (LVM) have shown inconsistent results. We aimed to evaluate cardiac function before and during replacement therapy employing...... the gold standard method cardiac magnetic resonance imaging (CMRI) and measurements of circulating levels of B-type natriuretic peptides. Sixteen patients (8 males and 8 females, mean age 49 years (range 18-75)) with severe GHD and 16 matched control subjects were included. CMRI was performed at baseline...... and after 1 year of GH replacement therapy. IGF-I, B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) were measured after 0, 1, 2, 3, 6 and 12 months of treatment. IGF-I Z-score increased from (median (IQR)) -2.3 (-3.8 to -1.4) to 0.5 (-0.3 to 1.7). LVM index (LVMI), ejection fraction...

  1. Multicenter evaluation of dual-therapy (omeprazol and amoxycillin) for Helicobacter pylori-associated duodenal and gastric ulcer (two years of the observation).

    Science.gov (United States)

    Gabryelewicz, A; Laszewicz, W; Dzieniszewski, J; Ciok, J; Marlicz, K; Bielecki, D; Popiela, T; Legutko, J; Knapik, Z; Poniewierka, E

    1997-09-01

    Treatment with the proton pump inhibitor (omeprazole) and single antibiotic (amoxycillin), two synergistic compounds, can cure Helicobacter pylori (H. pylori) infection, but this therapy is not as effective as had been expected. However, some studies show promising results. The aim of our study was to evaluate the effect of two weeks dual-therapy with omeprazole (O) and amoxycillin (A) on gastric (GU) and duodenal ulcer (DU) patients: ulcer healing, eradication of the H. pylori and recurrence rate of the ulcer. We studied 216 patients (aged 18-70) endoscopically proven GU (58 patients) and DU (158 patients). Rapid urease test from the two antrum biopses and two antral and two corporeal biopses using Giemsa stain method for confirmation of the H. pylori infection were used. The patients were treated with omeprazole 20 mg BID and amoxycillin 1.0 g BID for 2 weeks and investigated every 4 months during 2 years. Clearance effect of Hp infection was achieved in 65.1% GU and 66.4% DU patients. Eradication ("check point" after 4 months) in 43% DU and 56.6% GU patients was confirmed. Reinfection rate was found in 16% during 2 years. We conclude--dual-therapy (O and A) is not sufficiently effective to be recommended as an anti-H. pylori treatment. H. pylori eradication prevents recurrence of peptic ulcer and is an important issue in attempts to achieve permanent ulcer healing.

  2. Mortality in primary angioplasty patients starting antiplatelet therapy with prehospital prasugrel or clopidogrel: a 1-year follow-up from the European MULTIPRAC Registry

    Directory of Open Access Journals (Sweden)

    Goldstein P

    2016-04-01

    Full Text Available Patrick Goldstein,1 Niccolò Grieco,2 Hüseyin Ince,3,4 Nicolas Danchin,5 Yvonne Ramos,6 Jochen Goedicke,7 Peter Clemmensen8,9 On behalf of the MULTIPRAC study investigators 1Emergency Department, Lille Regional University Hospital, Lille, France; 2Department of Cardiology, Hospital Niguarda Cà Granda Milano, Milan, Italy; 3Internal Medicine Centre, Cardiology Department, Rostock University Clinic, Rostock, Germany; 4Department of Cardiology, Vivantes Klinikum im Friedrichshain and Am Urban, Berlin, Germany; 5Department of Cardiology, European Hospital Georges-Pompidou, Paris, France; 6Medical Department, Daiichi Sankyo Europe, Munich, 7Medical Department, Lilly Deutschland GmbH, Bad Homburg, Germany; 8Department of Medicine, Division of Cardiology, Rigshospitalet Copenhagen University Hospital, 9Department of Medicine, Division of Cardiology, Nykoebing F Hospital, Copenhagen, Denmark Aim: MULTIPRAC was designed to provide insights into the use and outcomes associated with prehospital initiation of antiplatelet therapy with either prasugrel or clopidogrel in the context of primary percutaneous coronary intervention. After a previous report on efficacy and safety outcomes during hospitalization, we report here the 1-year follow-up data, including cardiovascular (CV mortality. Methods and results: MULTIPRAC is a multinational, prospective registry of patients with ST-elevation myocardial infarction (STEMI from 25 hospitals in nine countries, all of which had an established practice of prehospital start of dual antiplatelet therapy in place. The key outcome was CV death at 1 year. Among 2,036 patients followed-up through 1 year, 49 died (2.4%, 10 during the initial hospitalization and 39 within 1 year after hospital discharge. The primary analysis was based on the P2Y12-inhibitor, used from prehospital loading dose through hospital disch